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are prone to having more severe symptoms compared to females and those with hypermethylation at the OPRM1 and COMT gene sites experience more severe symptoms as well. Symptoms can also appear and disappear and fluctuate in severity over time within the same infant and withdrawal period. Untreated NAS symptoms can cause developmental issues such as altered cognitive, social, emotional, and behavioral capacities that appear later in life. Long term effects vary by the substance that the neonate gets exposed to but they most commonly have been shown to affect growth, behavior, cognitive function, vision problems, motor problems, language, academic achievement, otitis media (infection or inflammation of the middel ear), and predisposition to self utilization of drugs. Substance examples of long term effects as follows: Alcohol exposure has shown it could lead to poor growth. Tobacco exposure can make it more likely to get obese. Alcohol, nicotine, and opiate exposure have shown to lead to attention deficits. Nicotine and alcohol exposure affect learning and memory. Cocaine exposure effects visual and motor skills, attention, and memory. Marijuana has been shown to have adverse effects on deep problem solving skills and visual memory. Nicotine exposure has shown poor reading abilities, alcohol showed a decreased use of language, and language delays for cocaine. Opioid exposure has shown visual impairments such as reduced ability to see fine detail and uncontrolled eye movements. Heroin exposure led to lower weight, height, and head circumference as well as decreased cognitive function that resulted in lower perceptual, quantitatve, and memory ares of cognition. Some common drugs that could result in NAS withdrawal or withdrawal-like symptoms in neonates are opioids; agonists such as morphine, codeine, methadone, meperidine, oxycodone, propoxyphene, hydromorphone, hydrocodone, fentanyl, tramadol, and heroin, antagonists such as naloxone, and naltrexone, and mixed agonist-antagonists like pentazocine and buprenorphine. CNS stimulants; Amphetamines such as dextroamphetamine, methamphetamine, amphetamine sulfate, amphetamine congeners, benzphetamine, diethylpropion, fenfluramine, phendimetrazine, phentermine, cocaine, methylphenidate, pemoline, phencyclidines, and nicotine. CNS depressants; alcohol, barbiturates, benzodiazepines, other sedative hypnotics, methaqualone, glutethimide, chloral, hydrate, cannabinoids, marijuana, and hashish. Hallucinogens; indolealkylamines, phenylethylamines, phenylisopropylamine, inhalants, solvents and aerosols, nitrites, and
105:
appear as soon as 24 to 48 hours and as late as 5 to 10 days after birth. If the neonate (a newborn less than 4 weeks of age) is expected to have NAS, they may need to stay in the hospital to be monitored for a week. A baby born at full-term may commonly exhibit symptoms such as mottling (net-like bluish-red skin due to swollen blood vessels), irritability, trembling, excessive or high-pitched crying, sleeping problems, increased muscle tone, overactive reflexes, seizures, yawning, stuffy nose, sneezing, poor feeding, rapid breathing, slow weight gain, vomiting, diarrhea, sweating, fever or unstable temperature. These symptoms mainly arise from the dysregulation of 4 physiological and or behavioral systems; state control and attention which influence irritability and avoidance of eye contact, motor and tone control which influence tremors and seizures, sensory processing which influence hypersensitivity or hyposensitivity, and autonomic control which influence patterns of respiration and fever. Each of which can influence the dysregulation of another system. For example, hypersensitivity in the sensory processing system can cause poor feeding due to the inability to relax, which therefore ultimately results in weight loss or poor weight gain. Signs and symptoms are also grouped into three systems by the
Finnegan Neonatal Abstinence Scoring System (FNASS). The central nervous system grouping which includes deficiencies in sleep after eating and myoclonic (uncontrolled movement) jerk. The metabolic, vasomotro, and respiratory grouping which include symptoms like a stuffy nose and tachypnea. And the gastrointestinal grouping which include excessive sucking and poor feeding. Babies born prematurely (before 37 weeks) often exhibit less symptoms or in less severity than those born at full term (38 to 42 weeks). This is due to being exposed to the drug for a lesser period of time during pregnancy. Premature babies with NAS tend to recover at a much faster rate than a full term baby would.
52:
637:
neonates born with addiction or experiencing withdrawal symptoms are increasing at an undesirable rate in North Bay from 22 babies in 2012-2013 to 48 babies born with NAS in 2014-2015. Furthermore, North Bay
Regional Health Centre was home to 10 NAS babies in January 2016 alone. The dramatic growth in numbers of neonates born with drug addiction will continue to grow if not confronted and managed in a way that is specific and appropriate for the city of North Bay.
139:
group does more frequently. Compared to the control group, the cocaine-exposed infants share a few features which includes jittery, tremors, irritable, excessive suck, extreme alertness, abnormal breathing and autonomic instability. Based on how much of the drug the infant was exposed to, there is a positive dose-response relationship between exposure of cocaine and hyperactivity along with the adaptability to its environment.
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incidence, with lows and highs ranging from 0.7 per 1,000 births in Hawaii, to 33.4 per 1,000 births in West
Virginia. This contrasts could potentially come as a result of illegal opioid use prevalence, difference in state to state opioid prescribing rates, and/or the use of NAS diagnosis, all making it difficult to average national incidence of NAS.
508:, all infants who have been exposed to chronic opioid use of the birthing parent during pregnancy must be monitored for at least 72 hours. The guidelines go further into detail depending on the specific exposure: 3 days of monitoring if the substance were immediate-release opioids, 4-7 days if the substance was
619:
A 2017 Centers for
Disease Control (CDC) report stated that the number of babies born with NAS increased nationally by 82% from 2010 to 2017. This correlates to a NAS rate of 7.3 per 1,000 hospital births. This increase was seen for the majority of the states that participated, however with variation
435:
Objectives of management are to minimize negative outcomes and promote normal development. Supportive care is the first step in management, but this is typically not enough and is complemented with medication. As of 2023, there have been three main guidelines that provide recommendations in regard to
138:
is a vasoconstrictor which is the main mechanism that causes harm to the fetus and placenta. As the drug is capable of crossing the blood-brain barrier and placenta, they will experience shortcomings. In a randomized case-controlled prospective study, there are a few characteristic traits the exposed
594:
Opioids such as neonatal morphine solution and methadone are commonly used to treat clinical symptoms of opiate withdrawal, but may prolong neonatal drug exposure and duration of hospitalization. A study demonstrated a shorter wean duration in infants treated with methadone compared to those treated
615:
A 2013 study examined the incidence of neonatal abstinence syndrome in 28 states. The researchers found that this rate increased by about 300% (from 1.5 cases to 6.0 cases per 1,000 hospital births) during 1999 to 2013. Along with these results, there have been considerable differences in state NAS
121:
There are pre- and post-natal exposure risk of neurobehavioral disorders. The exposure during pregnancy can alter the newborn infants' short and long term adverse effects. This can include low birth weight, reduced head circumference, cognitive deficits, emotional dysregulation, high impulsiveness,
627:
In 2024, a study evaluated the early results of the 2020 American
Academy of Pediatrics guidelines for managing neonatal opioid withdrawal symptoms. These guidelines proposed using non-pharmacological approaches as first line treatment. The study itself saw a reduction in infant NICU admission and
611:
In 2012, a study inspected information on hospital discharges across 44 states in the United States, which totaled to 7.4 million discharges. Their goal was to measure NAS trends over the past 10 years. The study found that the number of pregnant individuals using opiates increased from 1.2 to 5.6
108:
Both neonatal and maternal factors such as gestational age (length of pregnancy starting from the first day of the last mentrual period), maternal substance use, genetics, and gender play a role in the symptoms expressed by the neonate. Every infant is unique in which symptoms are expressed. Males
104:
Those diagnosed with NAS may exhibit signs and symptoms that vary depending on various factors. Factors such as the type of drugs used by the birthing parent, how long the drugs were used, the amount of drug used that made it to the child, and symptoms associated with premature birth. Symptoms can
636:
Neonatal abstinence syndrome is a growing health issue amongst the country. While
Ontario claims the highest rate of narcotic use in the country and one of the highest rates of prescription narcotic use in the world. Northern cities such as North bay are influential contributors. The number of
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NAS rates correlate with rates of opioid use disorder among pregnant individuals in the population. The misuse of opioids, along with other illicit substances by this group has increased since the early 2000s, all this while cases and this problem are likely being underreported.
484:, it is no longer recommended to admit infants to the NICU if they only have NAS since this can cause more problems that can aggravate symptoms due to the loud and overly stimulating environment as well as create a traumatic experience for the birthing parent.
343:
of NAS is determined through clinical assessment, neonatal testing, as well as diagnosis by exclusion to make sure that there are no other potential causes for the neonatal symptoms. Additional to assessing the neonate, full evaluation of the social and
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476:, then delivery of the infant must be done in a center that is equipped for monitoring of the infant for NAS. Traditionally, if an infant has been diagnosed with NAS after proper monitoring, then management of the disease is often handled in the
170:-exposed infants along with opioids may showcase more NAS signs. However, it is not certain if the effects is due to it being a transient drug effect or a true withdrawal. There can be increase in tone and alertness with poor self-regulation.
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is one of the most commonly used drugs. With long term exposure of alcohol from the pregnant individual to newborn infant, there are withdrawal symptoms from the central nervous system depressant. These traits were characterized by tremors,
214:
leading to increased opioid use among pregnant people. Although NAS generally includes opioid and nonopioid exposures, studies have shown that such cases have primarily resulted from in utero opioid exposure; thus, resulting in the use of
1482:
Convertino I, Sansone AC, Marino A, Galiulo MT, Mantarro S, Antonioli L, et al. (October 2016). "Neonatal
Adaptation Issues After Maternal Exposure to Prescription Drugs: Withdrawal Syndromes and Residual Pharmacological Effects".
234:
Although the main pathophysiology of NAS is still not fully understood, there are several potential mechanisms and pathways that are being investigated that may be related to the development of NAS caused by abnormal levels of
422:
of most drugs of concern. Although meconium and umbilical cord tissue testing provides a larger window of observation for substance exposure, it is not recommended if the birthing person is already receiving treatment for
623:
In 2023, the
American Academy of Pediatrics (AAP) estimated that the incidence of NAS increased to 8.8 cases per 1,000 hospital births. This study also stated that this rate varied by region, agreeing with prior studies.
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243:. Due to the differing substances that can lead to NAS, each substance can result in a different cause leading to the symptoms of NAS. Examples of such differences include: opioid withdrawal resulting in decreases in
96:. There are two types of NAS: prenatal and postnatal. Prenatal NAS is caused by discontinuation of drugs taken by the pregnant mother, while postnatal NAS is caused by discontinuation of drugs directly to the infant.
555:, it is recommended to use opioids with a longer half-life like buprenorphine and methadone, but it is important to take caution if the preparation has a high alcohol content. Additionally, it is recommended that
2687:
599:. When compared to morphine, methadone has a longer half-life in children, which allows for less frequent dosing intervals and steady serum concentrations to prevent neonatal withdrawal symptoms.
2577:
Patrick SW, Schumacher RE, Benneyworth BD, Krans EE, McAllister JM, Davis MM (May 2012). "Neonatal abstinence syndrome and associated health care expenditures: United States, 2000-2009".
2402:
Patrick SW, Schumacher RE, Benneyworth BD, Krans EE, McAllister JM, Davis MM (May 2012). "Neonatal abstinence syndrome and associated health care expenditures: United States, 2000-2009".
363:, also known as the Modified Finnegan Neonatal Abstinence Score. The scoring system assesses the neonate and observes the severity of the following characteristics: crying; sleeping;
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promotes infant attachment and bonding and is associated with a decreased need for medication. These approaches may lessen the severity of NAS and lead to shorter hospital stays.
437:
315:) have been associated with quicker recovery resulting in shorter duration of treatment. Environmental influences that can affect expression of the aforementioned genes, like
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is one of the recommended treatments for opioid withdrawal in adults, it is not recommended for the use of NAS due to the possibility of it precipitating rapid withdrawal and
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then the use of medications is to be considered. Medications are used to minimize clinical signs of withdrawal including fever, seizures, and weight loss or dehydration. When
453:
1588:
Piccotti L, Voigtman B, Vongsa R, Nellhaus EM, Rodriguez KJ, Davies TH, et al. (May 2019). "Neonatal Opioid
Withdrawal Syndrome: A Developmental Care Approach".
187:
540:
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Patrick SW, Barfield WD, Poindexter BB, COMMITTEE ON FETUS AND NEWBORN, COMMITTEE ON SUBSTANCE USE AND PREVENTION, Cummings J, Hand I, et al. (2020-11-01).
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that results in decreased OPRM1 gene expression, have also been associated with increased severity of NAS. Some non-genetic risk factors include smoking and
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Newborn infants with cocaine exposure during neonate manifests abnormal neurobehavioral. This is typically found between 48 hours and 72 hours of life.
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2647:
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tissue. Although these tests are recommended per guidelines, there are several considerations to understand when performing these tests. With urine
2527:
Hahn PD, Graham DA, Ozonoff A, Milliren CE (July 2024). "Neonatal Opioid
Withdrawal Syndrome Treatment Guidelines and Birth Hospital Utilization".
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183:
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and higher risk to develop a substance disorder. It can range from childhood, adolescence and early adulthood. While mixture with other drugs,
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is deemed necessary for severe opioid withdrawal, opioids are the treatment of choice and then they are slowly tapered down. According to the
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tests, samples must be collected immediately after birth since these tests only capture a short window of substance exposure due to the rapid
1676:
1257:
2973:
2621:
Journal of Population Therapeutics and Clinical Pharmacology = Journal de la Therapeutique des Populations et de la Pharmacologie Clinique
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1518:
Iqbal MM, Sobhan T, Ryals T (January 2002). "Effects of commonly used benzodiazepines on the fetus, the neonate, and the nursing infant".
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pharmacological treatments. More data is needed to evaluate the change in incidence trends after implementation of these guidelines.
2438:"Hudak ML, Tan RC, The Committee on Drugs and the Committee on Fetus and Newborn. Neonatal Drug Withdrawal. Pediatrics . 2012;129;e540"
2978:
88:, and withdrawal may occur as a result of repeated administration of drugs or even after short-term high-dose use—for example, during
1034:
Hudak ML, Tan RC, THE COMMITTEE ON DRUGS, THE COMMITTEE ON FETUS AND NEWBORN, Frattarelli DA, Galinkin JL, et al. (2012-02-01).
496:, it is recommended that if the birthing parent has a history of opioid use during pregnancy, then the infant must be monitored by a
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359:
being presented by the neonate at risk of NAS. The main scoring system associated with this standardized assessment is the modified
391:; and many others. This same assessment can be used in assessing the response that the neonate is having to the chosen treatment.
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3274:
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977:
Behnke M, Smith VC, COMMITTEE ON SUBSTANCE ABUSE, COMMITTEE ON FETUS AND NEWBORN, Behnke M, Smith VC, et al. (2013-03-01).
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3316:
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735:
263:; TCA withdrawal resulting in a cholinergic rebound phenomenon; benzodiazepine withdrawal resulting in an increased release of
156:
155:, restlessness, excessive mouthing movements, inconsolable crying and reflex abnormalities. There are direct effects known as
2193:
Osborn DA, Jeffery HE, Cole MJ (October 2010). Osborn DA (ed.). "Opiate treatment for opiate withdrawal in newborn infants".
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332:
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for the possibility of NAS. Unfortunately these guidelines do not specify the length of monitoring. As of 2020 though, the
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312:
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Osborn DA, Jeffery HE, Cole MJ (October 2010). Osborn DA (ed.). "Sedatives for opiate withdrawal in newborn infants".
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in utero) in the sense that such symptoms are difficult to separate in the context of other factors such as
2613:
1199:
de Moraes Barros MC, Guinsburg R, de AraĂşjo Peres C, Mitsuhiro S, Chalem E, Laranjeira RR (December 2006).
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3022:
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89:
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the infant in a blanket, minimizing environmental stimuli, and monitoring sleeping and feeding patterns.
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504:
provided more specific guidance in regards to the timeline recommended for monitoring. According to the
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1984:
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mainly consists of performing a standardized assessment to measure both the presence and severity of
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Navarrete F, GarcĂa-GutiĂ©rrez MS, Gasparyan A, Austrich-Olivares A, FemenĂa T, Manzanares J (2020).
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Maguire DJ, Taylor S, Armstrong K, Shaffer-Hudkins E, Germain AM, Brooks SS, et al. (2016).
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are usually prioritized for the treatment of infants with NAS, but for those experiencing severe
267:(GABA); and methamphetamine withdrawal resulting in a decrease in dopamine, serotonin, and other
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Patrick SW, Barfield WD, Poindexter BB (November 2020). "Neonatal Opioid Withdrawal Syndrome".
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427:(OUD) with frequent toxicology testing since this will not provide any additional information.
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17:
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Wachman EM, Hayes MJ, Brown MS, Paul J, Harvey-Wilkes K, Terrin N, et al. (May 2013).
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use of the birthing person during pregnancy that can result in increased severity of NAS.
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2989:
2909:
1201:"Exposure to marijuana during pregnancy alters neurobehavior in the early neonatal period"
548:
356:
345:
316:
296:
240:
207:
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123:
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2477:"Neonatal Abstinence Syndrome and Maternal Opioid-Related Diagnoses in the US, 2010-2017"
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2995:
2836:
2233:
2202:
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to name a few. Opioids have become the most associated with NAS due to the growing
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2711:
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2492:
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219:(NOWS) as a subset of NAS. Neonatal abstinence syndrome does not happen in
80:, caused by the cessation of the administration of licit or illicit drugs.
1958:
1881:
1842:
472:, it is recommended that if a pregnant individual has been diagnosed with
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is sometimes used as an alternative but is less effective in suppressing
564:
560:
403:
288:
284:
248:
167:
2768:
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568:
224:
195:
179:
135:
2772:
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368:
77:
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Non-medication based approaches to treat neonatal symptoms include
287:, can contribute to the severity of NAS and the recovery process.
3156:
2903:
2353:
Johnson MR, Nash DR, Laird MR, Kiley RC, Martinez MA (July 2014).
512:
and sustained-released opioids, and 5-7 days if the substance was
399:
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2475:
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436:
the treatment and prevention of NAS: 2023 guidelines from the
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583:
for neonatal opiate withdrawal symptoms. In the case of
2112:
Journal of Obstetric, Gynecologic, and Neonatal Nursing
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454:
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39:
34:
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2226:The Cochrane Database of Systematic Reviews
2195:The Cochrane Database of Systematic Reviews
760:"Neonate: MedlinePlus Medical Encyclopedia"
651:
649:
379:of chin, knees, elbows, toes, and/or nose;
2956:
2730:
2702:
2688:
2680:
348:of the birthing person must also be done.
331:According to the 2020 guidelines from the
74:neonatal opioid withdrawal syndrome (NOWS)
50:
31:
2500:
2378:
2329:
2280:
2131:
1717:
1175:
1157:
1116:
1098:
1010:
835:
279:Several studies have shown that multiple
579:; however, phenobarbital is superior to
351:Clinical assessment as described by the
1391:Pichini S, Garcia-Algar O (June 2006).
645:
184:selective serotonin reuptake inhibitors
1765:
1763:
1761:
1759:
1757:
612:per 1,000 hospital births every year.
2522:
2520:
2028:
2026:
1978:
1976:
1772:"Neonatal Opioid Withdrawal Syndrome"
1755:
1753:
1751:
1749:
1747:
1745:
1743:
1741:
1739:
1737:
1629:
1627:
1625:
1623:
1621:
1619:
1442:
1440:
1438:
1436:
1434:
859:Grossman M, Berkwitt A (2019-04-01).
810:Jansson LM, Patrick SW (2019-04-01).
231:or prenatal exposure to other drugs.
7:
2974:Infant respiratory distress syndrome
1249:Children With Prenatal Drug Exposure
805:
803:
730:
728:
726:
701:
699:
452:), and the 2017 guidelines from the
2087:. U.S. National Library of Medicine
1947:The New England Journal of Medicine
1246:Chandler LS, Lane SJ (2014-06-03).
217:Neonatal Opioid Withdrawal Syndrome
2979:Transient tachypnea of the newborn
2310:Clinical Obstetrics and Gynecology
2261:Pediatric Clinics of North America
1409:10.1097/01.ftd.0000211809.81816.1b
816:Pediatric Clinics of North America
25:
2757:Twin-to-twin transfusion syndrome
283:, ranging from social aspects to
3275:Vertically transmitted infection
2124:10.1111/j.1552-6909.2011.01330.x
1913:10.1097/00129804-200505000-00003
541:Nonpharmacological interventions
299:expression (mu-opioid receptors
3367:Fetal Alcohol Spectrum Disorder
3317:Group B streptococcal infection
2885:Intrauterine growth restriction
591:is an emerging add-on therapy.
178:The drugs involved can include
157:fetal alcohol spectrum disorder
2710:Conditions originating in the
2234:10.1002/14651858.CD002053.pub3
2203:10.1002/14651858.CD002059.pub3
2081:"Neonatal abstinence Syndrome"
1636:"Neonatal Abstinence Syndrome"
900:"Neonatal Abstinence Syndrome"
861:"Neonatal abstinence syndrome"
812:"Neonatal Abstinence Syndrome"
736:"Neonatal Abstinence Syndrome"
520:Nonpharmacologic Interventions
446:American Academy of Pediatrics
333:American Academy of Pediatrics
1:
3059:Vitamin K deficiency bleeding
877:10.1053/j.semperi.2019.01.007
682:10.1053/j.semperi.2007.07.002
239:and inadequate expression of
3218:Periventricular leukomalacia
3036:Persistent fetal circulation
2984:Meconium aspiration syndrome
2322:10.1097/GRF.0b013e31827feea4
2050:10.1097/AOG.0000000000002235
1895:Beauman SS (May–June 2005).
656:Neonatal Abstinence Syndrome
478:Neonatal Intensive Care Unit
444:), 2020 guidelines from the
76:is a withdrawal syndrome of
66:neonatal abstinence syndrome
18:Neonatal abstinence syndrome
3127:Intraventricular hemorrhage
2038:Obstetrics & Gynecology
1901:Journal of Infusion Nursing
1397:Therapeutic Drug Monitoring
1217:10.1016/j.jpeds.2006.08.046
3409:
3132:Germinal matrix hemorrhage
3122:Velamentous cord insertion
3013:Bronchopulmonary dysplasia
2448:(5): 937–938. 2014-05-01.
2371:10.5863/1551-6776-19.3.165
2001:10.1016/j.jogc.2023.05.012
1602:10.1891/0730-0832.38.3.160
1291:10.1001/archpedi.159.9.824
1036:"Neonatal Drug Withdrawal"
948:10.1891/0730-0832.35.5.277
3162:Necrotizing enterocolitis
2871:Large for gestational age
2867:Small for gestational age
2273:10.1016/j.pcl.2012.07.006
1497:10.1007/s40264-016-0435-8
1205:The Journal of Pediatrics
1159:10.3389/fpsyt.2020.586447
1100:10.3389/fpsyt.2020.586447
828:10.1016/j.pcl.2018.12.006
740:www.stanfordchildrens.org
221:prenatal cocaine exposure
192:tricyclic antidepressants
2541:10.1542/peds.2023-063635
1788:10.1542/peds.2020-029074
1567:10.1542/peds.2020-029074
1362:10.1891/0730-0832.33.1.5
865:Seminars in Perinatology
670:Seminars in Perinatology
223:(with babies exposed to
3324:Neonatal conjunctivitis
2815:Single umbilical artery
2805:Umbilical cord prolapse
2752:Placental insufficiency
2725:complicating pregnancy,
2493:10.1001/jama.2020.24991
1532:10.1176/appi.ps.53.1.39
1146:Frontiers in Psychiatry
1087:Frontiers in Psychiatry
3300:ureaplasma urealyticum
3008:Wilson–Mikity syndrome
2932:Brachial plexus injury
2591:10.1001/jama.2012.3951
2454:10.1542/peds.2014-0557
2416:10.1001/jama.2012.3951
2172:10.1542/peds.2011-3212
1710:10.1001/jama.2013.3411
1461:10.1542/peds.2013-3524
1052:10.1542/peds.2011-3212
995:10.1542/peds.2012-3931
474:substance use disorder
90:mechanical ventilation
3248:Congenital hypertonia
3139:Anemia of prematurity
2847:Shoulder presentation
2044:(2): e81–e94. 2017 .
1959:10.1056/NEJMra1600879
3388:Withdrawal syndromes
3253:Congenital hypotonia
3167:Meconium peritonitis
2969:Intrauterine hypoxia
2925:Subgaleal hemorrhage
1520:Psychiatric Services
494:ACOG 2017 Guidelines
470:SOGC 2023 Guidelines
458:ACOG 2017 Guidelines
456:(referred to as the
448:(referred to as the
442:SOGC 2023 Guidelines
440:(referred to as the
335:(referred to as the
251:with an increase in
94:intensive care units
3362:Neonatal withdrawal
3345:Perinatal mortality
3195:Sclerema neonatorum
3051:hematologic disease
553:AAP 2020 Guidelines
506:AAP 2020 Guidelines
502:AAP 2020 Guidelines
482:AAP 2020 Guidelines
480:(NICU). As per the
450:AAP 2020 Guidelines
425:opioid use disorder
396:AAP 2020 Guidelines
357:withdrawal symptoms
353:AAP 2020 Guidelines
337:AAP 2020 Guidelines
265:g-aminobutyric acid
62:Neonatal withdrawal
35:Neonatal withdrawal
3295:mycoplasma hominis
3280:Neonatal infection
3236:Gray baby syndrome
3213:Perinatal asphyxia
3103:Hyperbilirubinemia
2880:Postterm pregnancy
2727:labour or delivery
1862:Addictive Diseases
1561:(5): e2020029074.
989:(3): e1009–e1024.
100:Signs and symptoms
3375:
3374:
3263:
3262:
3113:Neonatal jaundice
3031:Pneumopericardium
3001:Pneumomediastinum
2942:Klumpke paralysis
2920:Caput succedaneum
2855:
2854:
2723:Maternal factors
2646:Leslie K (2015).
2585:(18): 1934–1940.
2410:(18): 1934–1940.
1953:(25): 2468–2479.
1704:(17): 1821–1827.
1678:978-1-4129-5646-8
1344:Liska SR (2014).
1259:978-1-317-82688-0
620:between states.
597:tincture of opium
585:sedative-hypnotic
545:opioid withdrawal
492:According to the
468:According to the
394:According to the
237:neurotransmitters
59:
58:
29:Medical condition
16:(Redirected from
3400:
3355:Infant mortality
3190:Erythema toxicum
3182:thermoregulation
3149:Gastrointestinal
2957:
2953:Affected systems
2830:
2798:
2783:Chorioamnionitis
2776:
2747:Placenta praevia
2740:
2731:
2704:
2697:
2690:
2681:
2675:
2674:
2662:
2656:
2655:
2643:
2637:
2636:
2618:
2609:
2603:
2602:
2574:
2568:
2566:
2559:
2553:
2552:
2524:
2515:
2514:
2504:
2472:
2466:
2465:
2434:
2428:
2427:
2399:
2393:
2392:
2382:
2350:
2344:
2343:
2333:
2301:
2295:
2294:
2284:
2267:(5): 1147–1165.
2252:
2246:
2245:
2228:(10): CD002053.
2221:
2215:
2214:
2197:(10): CD002059.
2190:
2184:
2183:
2166:(2): e540–e560.
2155:
2146:
2145:
2135:
2103:
2097:
2096:
2094:
2092:
2076:
2070:
2069:
2030:
2021:
2020:
1980:
1971:
1970:
1942:
1933:
1932:
1892:
1886:
1885:
1868:(1–2): 141–158.
1853:
1847:
1846:
1814:
1808:
1807:
1767:
1732:
1731:
1721:
1689:
1683:
1682:
1664:
1658:
1657:
1655:
1654:
1631:
1614:
1613:
1590:Neonatal Network
1585:
1579:
1578:
1550:
1544:
1543:
1515:
1509:
1508:
1479:
1473:
1472:
1455:(2): e547–e561.
1444:
1429:
1428:
1388:
1382:
1381:
1350:Neonatal Network
1341:
1335:
1334:
1332:
1331:
1317:
1311:
1310:
1270:
1264:
1263:
1243:
1237:
1236:
1196:
1190:
1189:
1179:
1161:
1137:
1131:
1130:
1120:
1102:
1078:
1072:
1071:
1046:(2): e540–e560.
1031:
1025:
1024:
1014:
974:
968:
967:
936:Neonatal Network
927:
921:
920:
919:
918:
895:
889:
888:
856:
850:
849:
839:
807:
798:
797:
795:
794:
780:
774:
773:
771:
770:
756:
750:
749:
747:
746:
732:
721:
720:
718:
717:
703:
694:
693:
665:
659:
653:
241:opioid receptors
208:muscle relaxants
55:
54:
32:
21:
3408:
3407:
3403:
3402:
3401:
3399:
3398:
3397:
3378:
3377:
3376:
3371:
3328:
3312:Neonatal sepsis
3259:
3228:Musculoskeletal
3222:
3199:
3180:
3171:
3143:
3098:Hydrops fetalis
3049:
3040:
3017:
2990:Pleural disease
2948:
2910:Cephalohematoma
2889:
2851:
2824:
2819:
2792:
2787:
2766:
2761:
2734:
2726:
2724:
2718:
2708:
2678:
2664:
2663:
2659:
2645:
2644:
2640:
2627:(3): e488–506.
2616:
2611:
2610:
2606:
2576:
2575:
2571:
2561:
2560:
2556:
2526:
2525:
2518:
2474:
2473:
2469:
2436:
2435:
2431:
2401:
2400:
2396:
2352:
2351:
2347:
2303:
2302:
2298:
2254:
2253:
2249:
2223:
2222:
2218:
2192:
2191:
2187:
2157:
2156:
2149:
2105:
2104:
2100:
2090:
2088:
2078:
2077:
2073:
2032:
2031:
2024:
1982:
1981:
1974:
1944:
1943:
1936:
1894:
1893:
1889:
1855:
1854:
1850:
1816:
1815:
1811:
1769:
1768:
1735:
1691:
1690:
1686:
1679:
1666:
1665:
1661:
1652:
1650:
1633:
1632:
1617:
1587:
1586:
1582:
1552:
1551:
1547:
1517:
1516:
1512:
1491:(10): 903–924.
1481:
1480:
1476:
1446:
1445:
1432:
1390:
1389:
1385:
1343:
1342:
1338:
1329:
1327:
1319:
1318:
1314:
1272:
1271:
1267:
1260:
1245:
1244:
1240:
1198:
1197:
1193:
1139:
1138:
1134:
1080:
1079:
1075:
1033:
1032:
1028:
976:
975:
971:
929:
928:
924:
916:
914:
897:
896:
892:
858:
857:
853:
809:
808:
801:
792:
790:
788:medlineplus.gov
782:
781:
777:
768:
766:
764:medlineplus.gov
758:
757:
753:
744:
742:
734:
733:
724:
715:
713:
711:medlineplus.gov
705:
704:
697:
667:
666:
662:
654:
647:
643:
634:
605:
559:and deodorized
549:pharmacotherapy
538:
536:Pharmacotherapy
522:
490:
466:
464:Setting of Care
433:
381:myoclonic jerks
346:medical history
329:
317:DNA methylation
297:opioid receptor
277:
204:anticonvulsants
200:benzodiazepines
176:
165:
145:
132:
119:
102:
49:
30:
23:
22:
15:
12:
11:
5:
3406:
3404:
3396:
3395:
3390:
3380:
3379:
3373:
3372:
3370:
3369:
3364:
3359:
3358:
3357:
3352:
3342:
3336:
3334:
3330:
3329:
3327:
3326:
3321:
3320:
3319:
3309:
3304:
3303:
3302:
3297:
3292:
3290:herpes simplex
3287:
3277:
3271:
3269:
3265:
3264:
3261:
3260:
3258:
3257:
3256:
3255:
3250:
3238:
3232:
3230:
3224:
3223:
3221:
3220:
3215:
3209:
3207:
3205:Nervous system
3201:
3200:
3198:
3197:
3192:
3186:
3184:
3173:
3172:
3170:
3169:
3164:
3159:
3153:
3151:
3145:
3144:
3142:
3141:
3136:
3135:
3134:
3124:
3118:
3117:
3116:
3115:
3110:
3100:
3095:
3094:
3093:
3088:
3083:
3078:
3073:
3062:
3061:
3055:
3053:
3042:
3041:
3039:
3038:
3033:
3027:
3025:
3023:Cardiovascular
3019:
3018:
3016:
3015:
3010:
3005:
3004:
3003:
2998:
2986:
2981:
2976:
2971:
2965:
2963:
2954:
2950:
2949:
2947:
2946:
2945:
2944:
2939:
2929:
2928:
2927:
2922:
2917:
2912:
2899:
2897:
2891:
2890:
2888:
2887:
2882:
2873:
2863:
2861:
2857:
2856:
2853:
2852:
2850:
2849:
2844:
2839:
2833:
2831:
2821:
2820:
2818:
2817:
2812:
2807:
2801:
2799:
2795:umbilical cord
2789:
2788:
2786:
2785:
2779:
2777:
2763:
2762:
2760:
2759:
2754:
2749:
2743:
2741:
2728:
2720:
2719:
2709:
2707:
2706:
2699:
2692:
2684:
2677:
2676:
2657:
2638:
2604:
2569:
2554:
2516:
2487:(2): 146–155.
2467:
2429:
2394:
2365:(3): 165–173.
2345:
2316:(1): 186–192.
2296:
2247:
2216:
2185:
2147:
2118:(2): 180–190.
2098:
2071:
2022:
1995:(11): 102144.
1972:
1934:
1907:(3): 159–167.
1887:
1848:
1829:(1–2): 19–32.
1809:
1733:
1684:
1677:
1659:
1615:
1596:(3): 160–169.
1580:
1545:
1510:
1474:
1430:
1403:(3): 288–290.
1383:
1336:
1312:
1285:(9): 824–834.
1265:
1258:
1238:
1211:(6): 781–787.
1191:
1132:
1073:
1026:
969:
942:(5): 277–286.
922:
890:
871:(3): 173–186.
851:
822:(2): 353–367.
799:
775:
751:
722:
695:
676:(5): 289–297.
660:
644:
642:
639:
633:
630:
604:
601:
537:
534:
521:
518:
489:
486:
465:
462:
432:
429:
408:umbilical cord
383:; generalized
361:Finnegan score
328:
325:
276:
273:
257:norepinephrine
253:corticotrophin
175:
172:
164:
161:
144:
141:
131:
128:
118:
115:
101:
98:
57:
56:
43:
37:
36:
28:
24:
14:
13:
10:
9:
6:
4:
3:
2:
3405:
3394:
3391:
3389:
3386:
3385:
3383:
3368:
3365:
3363:
3360:
3356:
3353:
3351:
3348:
3347:
3346:
3343:
3341:
3338:
3337:
3335:
3331:
3325:
3322:
3318:
3315:
3314:
3313:
3310:
3308:
3305:
3301:
3298:
3296:
3293:
3291:
3288:
3286:
3283:
3282:
3281:
3278:
3276:
3273:
3272:
3270:
3266:
3254:
3251:
3249:
3246:
3245:
3244:
3243:
3239:
3237:
3234:
3233:
3231:
3229:
3225:
3219:
3216:
3214:
3211:
3210:
3208:
3206:
3202:
3196:
3193:
3191:
3188:
3187:
3185:
3183:
3178:
3174:
3168:
3165:
3163:
3160:
3158:
3155:
3154:
3152:
3150:
3146:
3140:
3137:
3133:
3130:
3129:
3128:
3125:
3123:
3120:
3119:
3114:
3111:
3109:
3106:
3105:
3104:
3101:
3099:
3096:
3092:
3089:
3087:
3084:
3082:
3079:
3077:
3074:
3072:
3069:
3068:
3067:
3064:
3063:
3060:
3057:
3056:
3054:
3052:
3047:
3043:
3037:
3034:
3032:
3029:
3028:
3026:
3024:
3020:
3014:
3011:
3009:
3006:
3002:
2999:
2997:
2994:
2993:
2992:
2991:
2987:
2985:
2982:
2980:
2977:
2975:
2972:
2970:
2967:
2966:
2964:
2962:
2958:
2955:
2951:
2943:
2940:
2938:
2935:
2934:
2933:
2930:
2926:
2923:
2921:
2918:
2916:
2913:
2911:
2908:
2907:
2906:
2905:
2901:
2900:
2898:
2896:
2892:
2886:
2883:
2881:
2877:
2876:Preterm birth
2874:
2872:
2868:
2865:
2864:
2862:
2858:
2848:
2845:
2843:
2840:
2838:
2835:
2834:
2832:
2829:
2828:
2822:
2816:
2813:
2811:
2808:
2806:
2803:
2802:
2800:
2797:
2796:
2790:
2784:
2781:
2780:
2778:
2775:
2774:
2770:
2764:
2758:
2755:
2753:
2750:
2748:
2745:
2744:
2742:
2739:
2738:
2732:
2729:
2721:
2717:
2716:fetal disease
2713:
2705:
2700:
2698:
2693:
2691:
2686:
2685:
2682:
2672:
2668:
2661:
2658:
2653:
2649:
2642:
2639:
2634:
2630:
2626:
2622:
2615:
2608:
2605:
2600:
2596:
2592:
2588:
2584:
2580:
2573:
2570:
2564:
2558:
2555:
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