Cost of Neonatal Abstinence Syndrome: An Economic Analysis of English National Data held in the National Neonatal Research Database. The authors investigated the incidence of neonatal abstinence syndrome (NAS) across neonatal units, healthcare utilisation and the direct cost to the NHS in a population cohort study (2012-2017) in NHS neonatal units, using data (n=6411) held in the National Neonatal Research Database. NAS accounted for a substantial cot usage and economic costs of caring for infants in neonatal units, with nearly 12/1000 admissions and 23/1000 cot days nationally. Almost half of infants received pharmacotherapy and their time-to-discharge was significantly longer (median 18.2 vs 5.1 days). Time-to-discharge was longer for formula-fed infants and those discharged to foster care. The greatest predictor of additional care costs was receipt of pharmacotherapy.
Perinatal drug abuse and neonatal drug withdrawal. Drug abuse and addiction have significantly increased over the last few decades, particularly with opioid abuse and dependence. Drug abuse during pregnancy is a serious health risk for both mother and newborn infant. Infants exposed to maternal drugs in fetal life develop signs of drug withdrawal, which fortunately is not fatal, but still results in significant illness and prolonged hospitalization.
Baby STRENGTH: Eat, Sleep, Console for infants with Neonatal Abstinence Syndrome. Traditional medication-based management of neonatal abstinence syndrome (NAS) results in long hospitalizations. Non-pharmacologic treatment and using the Eat, Sleep, Console (ESC) model of care have been shown to decrease lengths of stay (LOS). In this retrospective study, the authors investigated whether the ESC model reduced the need for morphine for treatment of abstinence symptoms and reduced LOS when compared with traditional medication management. The found highly significant reductions in the need for morphine and the LOS. There was no difference in weight loss. The breastfeeding rates increased during the study period. These data are very encouraging and suggest a need for continued research on the long-term neurodevelopmental outcomes of infants managed using ESC principles.
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