Am J Perinatol 2020; 37(03): 326-332
DOI: 10.1055/s-0039-1700865
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Neonatal Abstinence Syndrome among Infants Born to Mothers with Sickle Cell Hemoglobinopathies

Jewel A. Brown
1   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of South Florida, Morsani College of Medicine, Tampa, Florida
,
Rachel G. Sinkey
1   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of South Florida, Morsani College of Medicine, Tampa, Florida
,
Thora S. Steffensen
2   Department of Pathology, Tampa General Hospital, Tampa, Florida
,
Adetola F. Louis-Jacques
1   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of South Florida, Morsani College of Medicine, Tampa, Florida
,
Judette M. Louis
1   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of South Florida, Morsani College of Medicine, Tampa, Florida
› Author Affiliations
Further Information

Publication History

14 May 2019

26 September 2019

Publication Date:
22 November 2019 (online)

Abstract

Objective The objective of this study is to examine risk factors for neonatal abstinence syndrome (NAS) among infants born to mothers with sickle cell hemoglobinopathies (SCH).

Study Design Retrospective cohort study of nonanomalous, singleton infants born to mothers with laboratory confirmed SCH. Infants were included if they were diagnosed with NAS prior to hospital discharge. The outcome of interest was the association of maternal variables with NAS.

Results Of 131 infants born to mothers with SCH, 4% (n = 5) were diagnosed with NAS. Mothers of infants with NAS were more likely to have SC disease (80%) compared with other SCH (20%), p = 0.001. Fifteen women had antepartum (AP) admissions for pain and/or sickle crisis. Of these patients, four infants (29%) were diagnosed with NAS. The median (5th and 95th percentile) maternal AP length of stay for women with infants diagnosed with NAS to mothers with sickle cell disease was 132 (5, 180) days (p = 0.02).

Conclusion Incidence of NAS among mothers with SCH is low; severe disease characterized by AP sickle cell crisis requiring prolonged AP admission for pain control significantly increases the risk of NAS. Further studies are needed to investigate the association of maternal opioid dose and NAS.

Note

This work was presented at the 2017 Annual Clinical and Scientific Meeting of the American College of Obstetricians and Gynecologists May 6 to 9, 2017 in San Diego, California.


 
  • References

  • 1 McQueen K, Murphy-Oikonen J. Neonatal abstinence syndrome. N Engl J Med 2016; 375 (25) 2468-2479
  • 2 Ko JY, Patrick SW, Tong VT, Patel R, Lind JN, Barfield WD. Incidence of neonatal abstinence syndrome—28 States, 1999-2013. MMWR Morb Mortal Wkly Rep 2016; 65 (31) 799-802
  • 3 Hudak ML, Tan RC. ; Committee on Drugs; Committee on Fetus and Newborn; American Academy of Pediatrics. Neonatal drug withdrawal. Pediatrics 2012; 129 (02) e540-e560
  • 4 Stover MW, Davis JM. Opioids in pregnancy and neonatal abstinence syndrome. Semin Perinatol 2015; 39 (07) 561-565
  • 5 Uebel H, Wright IM, Burns L. , et al. Reasons for rehospitalization in children who had neonatal abstinence syndrome. Pediatrics 2015; 136 (04) e811-e820
  • 6 Boga C, Ozdogu H. Pregnancy and sickle cell disease: a review of the current literature. Crit Rev Oncol Hematol 2016; 98: 364-374
  • 7 Ojodu J, Hulihan MM, Pope SN, Grant AM. ; Centers for Disease Control and Prevention (CDC). Incidence of sickle cell trait—United States, 2010. Morb Mortal Wkly Rep 2014; 63 (49) 1155-1158
  • 8 Sickle Cell Disease. Centers for Disease Control and Prevention. (2018). Available at: https://www.cdc.gov/ncbddd/sicklecell/facts.html . Accessed November 14, 2019
  • 9 Parrish MR, Morrison JC. Sickle cell crisis and pregnancy. Semin Perinatol 2013; 37 (04) 274-279
  • 10 Martí-Carvajal AJ, Peña-Martí GE, Comunián-Carrasco G, Martí-Peña AJ. Interventions for treating painful sickle cell crisis during pregnancy. Cochrane Database Syst Rev 2009; (01) CD006786
  • 11 Kocherlakota P. Neonatal abstinence syndrome. Pediatrics 2014; 134 (02) e547-e561
  • 12 Shirel T, Hubler CP, Shah R. , et al. Maternal opioid dose is associated with neonatal abstinence syndrome in children born to women with sickle cell disease. Am J Hematol 2016; 91 (04) 416-419
  • 13 Tolia VN, Patrick SW, Bennett MM. , et al. Increasing incidence of the neonatal abstinence syndrome in U.S. neonatal ICUs. N Engl J Med 2015; 372 (22) 2118-2126
  • 14 Patrick SW, Davis MM, Lehman CU, Cooper WO. Increasing incidence and geographic distribution of neonatal abstinence syndrome: United States 2009 to 2012. J Perinatol 2015; 35 (08) 667
  • 15 Weathers L, Driver K, Zaritt J. , et al. Safety, acceptability, and feasibility of auricular acupuncture in neonatal abstinence syndrome: a pilot study. Med Acupunct 2015 27(06):
  • 16 Yawn BP, Buchanan GR, Afenyi-Annan AN. , et al. Management of sickle cell disease: summary of the 2014 evidence-based report by expert panel members. JAMA 2014; 312 (10) 1033-1048
  • 17 Sinkey RG, Salihu HM, King LM. , et al. Homocysteine levels are not related to telomere length in cord blood leukocytes of newborns. Am J Perinatol 2016; 33 (06) 552-559