Identifying infants at risk for neonatal abstinence syndrome: a retrospective cohort comparison study of 3 screening approaches

abstract: OBJECTIVE: The main objective of this study was to analyze the consistency in using a standardized newborn toxicology screening protocol to identify infants at risk of developing neonatal abstinence syndrome (NAS). DESIGN: A retrospective cohort comparison design was approved by the institutional review board at the regional hospital and used to gather data from the infants' medical records during the study period. SETTING: The data were collected for a period of 1 year from a regional hospital serving 100,000 patients per annum. PATIENTS/PARTICIPANTS: Data were based on expectant mothers who delivered between March 2006 and March 2007. METHOD: Data of maternal self-reported substance use, and urine toxicology results and meconium results were obtained through retrospective chart review of infants exhibiting signs of NAS as noted by nurses on the Finnegan Scoring Tool. RESULTS: In the absence of accurate prenatal screening, this study lends positively to support the use of toxicology screening protocols at birth to adequately assess and treat infants exposed to illicit substances. Toxicology screening in not intrusive and despite emotional discomfort experienced by mothers of the infants tested, the benefits of attaining accurate information regarding substance exposure is critical for the well-being of the infant. CONCLUSION: The use of a toxicology screening protocol at birth appears beneficial in determining the need for identifying infants with NAS. Early detection of substance exposure in newborns leads to timely assessment for NAS and subsequent treatment to reduce symptoms in newborns