A 12 month review of infants admitted with
neonatal abstinence syndrome to a neonatal intensive care unit was undertaken. The relationship of maternal
drug abuse to symptoms, the effectiveness of pharmacologic agents in controlling symptoms and the length of inpatient stay were investigated. A retrospective review of maternal and infant records was performed. Those infants with a serial Finnegan score greater than 8 were treated. Pharmacologic treatment was oral
morphine sulphate (0.2 mg 4-6 hourly),
phenobarbitone (3-7 mgs/kg/day), or combination of the above. 43 infants were admitted to the hospital during the year. The average maternal age was 24.6 years, (18-34 years).
Drug use volunteered by the mothers was
methadone alone in 6 cases,
methadone and
benzodiazepines in 14,
methadone and
heroin and
benzodiazepines in 7,
methadone and
heroin in 10,
heroin alone in 2, and other multiple
drug use including oral
morphine sulphate,
dothiepin and cannabis in 4. Average gestational age was 40.3 (35-42 weeks). The average
birthweight was 2.81 kgs (1.89-3.91 kgs). Time to onset of
withdrawal symptoms was 2.8 (1-13) days. The duration of pharmacologic treatment (oral
morphine sulphate and/or
phenobarbitone) was 21.8 (1-62) days. The total
hospital stay for the 43 infants was 1,011 days. This study confirms that polydrug abuse is the commonest type of
drug abuse in Dublin. The duration of
withdrawal symptoms is loosely related to
drug type, but increasing duration of symptoms is noted for infants exposed to
benzodiazepines. Our experience would favour the use of
morphine sulphate to treat pure
opiate withdrawal symptoms. Over the 12-month period, there was an average occupancy of 3 beds per day in the paediatric department.