Neonatal withdrawal

Neonatal withdrawal
Classification and external resources
ICD-10	P96.1
ICD-9	779.5
DiseasesDB	33462
eMedicine	article/978763
MeSH	D009357

Neonatal withdrawal or neonatal abstinence syndrome (NAS) is a withdrawal syndrome of infants, caused by administration of drugs. Tolerance, dependence and withdrawal may occur as a result of repeated administration of drugs, or even after short-term high dose use for example during mechanical ventilation in intensive care units. There are two types of NAS: prenatal and postnatal. Prenatal NAS is caused by substance abuse by the pregnant mother, while postnatal NAS is caused by discontinuation of drugs directly to the infant.^[1][2]

The drugs involved may be for example opioids, selective serotonin reuptake inhibitors (SSRIs), alcohol and benzodiazepines.^[1][3] When pharmacological treatment of opiate withdrawal in neonates is deemed necessary, opiates are the treatment of choice, which are slowly tapered down to wean the neonate off opiates. Phenobarbitol is sometimes used as an alternative but is less effective in suppressing seizures; however, phenobarbitol is superior to diazepam for neonatal opiate withdrawal symptoms. In the case of sedative-hypnotic neonatal withdrawal, phenobarbitol is the treatment of choice.^[4][4]

Neonatal abstinence syndrome does not happen in prenatal cocaine exposure (with babies exposed to cocaine in utero); at least, such symptoms are difficult to separate in the context of other factors such as prematurity or prenatal exposure to other drugs.^[5]

References

1. ^ ^{a b} emedicine.com - Neonatal Abstinence Syndrome Author: Jaques Belik, MD
2. ^ Hall, RW.; Boyle, E.; Young, T. (Oct 2007). "Do ventilated neonates require pain management?". Semin Perinatol 31 (5): 289–97. doi:10.1053/j.semperi.2007.07.002. PMID 17905183. 
3. ^ Iqbal MM, Sobhan T, Ryals T (January 2002). "Effects of commonly used benzodiazepines on the fetus, the neonate, and the nursing infant". Psychiatric Services 53 (1): 39–49. doi:10.1176/appi.ps.53.1.39. PMID 11773648. http://ps.psychiatryonline.org/cgi/content/full/53/1/39. 
4. ^ ^{a b} Osborn, DA.; Jeffery, HE.; Cole, M. (2005). "Opiate treatment for opiate withdrawal in newborn infants." (PDF). Cochrane Database Syst Rev (3): CD002059. doi:10.1002/14651858.CD002059.pub2. PMID 16034871. http://mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD002059/pdf_fs.html. 
5. ^ Mercer, J (2009). "Claim 9: "Crack babies" can't be cured and will always have serious problems". Child Development: Myths and Misunderstandings. Thousand Oaks, Calif: Sage Publications, Inc. pp. 62–64. ISBN 1-4129-5646-3. 

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