For the study, published in the Journal of Perinatology, researchers looked at data from 1,424 infants with NAS at 14 major children’s hospitals and found significant variations in treatment.
“We found that, even among large children’s hospitals, only a couple of hospitals followed the same method of treatment more than 80 percent of the time,” says Stephen Patrick an assistant professor of pediatrics at Vanderbilt University, who completed the work as a neonatology fellow at the University of Michigan.
More Babies Born With NAS
“I think, overall, what this calls for is standardizing how we care for these infants as the American Academy of Pediatrics and World Health Organization suggests: making sure we are giving the same treatment using the best possible evidence that we can to improve outcomes for our babies and families.”
Recently, there has been a rapid increase in the number of infants born with NAS in the United States. Tennessee has been particularly affected. In some areas of the state, infants born with NAS make up 5 percent of all births, Patrick says.
The study looked at a combination of hospital administration and pharmacy data to evaluate differences in drug treatment for infants with NAS. Six hospitals primarily used methadone, six prescribed morphine, and two used phenobarbital. Methadone showed the best outcome.
Though more research is needed, Patrick says it is likely that methadone-treated infants will have fewer instances where they show signs of withdrawal.
Fewer signs of withdrawal could decrease the need for opioid dose escalations, potentially shortening their length of treatment and hospital stay.
“The problem with neonatal abstinence syndrome is there is not a lot of research to inform what we do. We hope to add to the evidence by comparing medications and by showing how variable care is for this vulnerable population. I hope our work will serve as a call to hospitals caring for infants with NAS to standardize how they care for patients,” Patrick says.
The Robert Wood Johnson Foundation Clinical Scholars Program, a collaboration among the Children’s Hospital of Philadelphia, Cincinnati Children’s Hospital, and the University of Michigan Health System, supported the study.”
Source:Vanderbilt University – July 24, 2014