Mean severity scores on the total NAS score and five individual signs (disturbed and undisturbed tremors, hyperactive Moro reflex, excessive irritability, failure to thrive) were significantly higher among methadone-exposed neonates, while sneezing was higher among buprenorphine-exposed neonates. Two NAS signs (undisturbed tremors and hyperactive Moro reflex) were observed significantly more frequently in methadone-exposed neonates and three (nasal stuffiness, sneezing, loose stools) were observed more frequently in buprenorphine-exposed neonates. The incidence and mean severity of the total NAS score and each individual sign of NAS were calculated and compared between medication conditions, as was the median time until morphine treatment initiation among treated infants in each condition. Data from neonates who required pharmacological treatment (methadone = 41, buprenorphine = 27) were included up to the time treatment was initiated. Measurementsįor 10 days after delivery, neonates (methadone = 72, buprenorphine = 57) were assessed regularly using a 19-item modified Finnegan scale. Data from a total of 129 neonates born to opioid-dependent women who had been assigned to receive methadone or buprenorphine treatment during pregnancy were examined. Secondary analysis of NAS data from a multi-site, double-blind, double-dummy, flexible-dosing, randomized clinical trial. Yawning: More than 3 times within the assessment interval.Įxcessive sucking: Rooting > 3 times per interval while displaying swiping movements with hand across mouth in attempt to suck on fist, hands, pacifier.To compare the profile of signs of neonatal abstinence syndrome (NAS) in methadone- versus buprenorphine-exposed infants. Sweating: Moisture on the forehead, upper lip, or back of the neck not due to over-wrapping. Myoclonic jerks: Twitching movements of the muscles of the face or extremities. Increased muscle tone: No head lag when being pulled to sitting position / total body rigidity / tight flexion of arms and legs.Įxcoriation: Skin irritation on chin, knees, cheeks, elbows, toes, or nose. Moderate - severe tremors undisturbed: Exhibits tremors of arms / legs while NOT being handled. Mild tremors undisturbed: Exhibits tremors of one or both hands / feet while NOT being handled.
Moderate tremors disturbed: Exhibits tremors of arms / legs while being handled or disturbed. Mild tremors disturbed: Exhibits tremors of one or both hands / feet while being handled or disturbed. Marked hyperactive Moro: Jitteriness and sustained clonus of the hands / arms during or after a Moro reflex. Hyperactive Moro: Exhibits pronounced jitteriness of the hands during or at the end of a moro reflex.
Sleep: Scoring based on the longest period of sleep displayed with the entire scoring interval. Excessive crying: Unable to use self-consoling measures (finger/fist sucking) or calm with interventions from the caregiver (holding, rocking, pacificier) from 5 seconds up to 5 minutes.Ĭontinuous crying: Continues to cry intermittently or continuously for > 5 minutes despite consoling measures.