Diagnosis of neonatal abstinence syndrome: Substance use During Pregnancy

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Internationally the use of prescribed medications is increasing to become a significant public health problem. The abuse of opioid analgesics is especially problematic with their use in pregnancy a growing but under reported problem.

The Case:
A male neonate (3.485 kg) suffered poor feeding, gastro-intestinal disturbance, hypoglycaemia, and respiratory distress. During pregnancy his mother was prescribed a variety of psychoactive medications including an opiate analgesic, an antidepressant, antipsychotic and benzodiazepine receptor agonist. A diagnosis of Neonatal Abstinence Syndrome (NAS) was made following unquantified maternal disclosure of tramadol misuse in pregnancy.

It is important to recognise the risk of prescribed medication abuse in pregnancy and the impact these problems may have on the fetus and neonate. A NAS following intrauterine exposure to opioid analgesics has been described clearly in the literature but evidence is limited to case studies and case series. It is important the management of these neonates includes a full maternal medication history, supported by neonatal toxicology, with an applied understanding of the potential neonatal consequences of different intrauterine medication exposures.
Original languageEnglish
Pages (from-to)43-48
Number of pages6
JournalHeroin Addiction And Related Clinical Problems
Issue number5
Publication statusPublished - 13 Jun 2016


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