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CC BY-NC-ND 4.0 · Am J Perinatol 2022; 39(08): 897-903
DOI: 10.1055/s-0040-1719182
Original Article

Rooming-in for Infants at Risk for Neonatal Abstinence Syndrome: Outcomes 5 Years following Its Introduction as the Standard of Care at One Hospital

Adam Isaiah Newman 
1   Department of Family Medicine, Queen's University, Kingston, Ontario, Canada
2   Department of Pediatrics, Queen's University, Kingston, Ontario, Canada
,
Dane Mauer-Vakil
3   Health Services Research Program, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
,
Helen Coo
2   Department of Pediatrics, Queen's University, Kingston, Ontario, Canada
,
Lynn Newton
1   Department of Family Medicine, Queen's University, Kingston, Ontario, Canada
2   Department of Pediatrics, Queen's University, Kingston, Ontario, Canada
4   Women's and Children's Program, Kingston Health Sciences Centre, Kingston, Ontario, Canada
5   School of Medicine, Queen's University, Kingston, Ontario, Canada
,
Emily Wilkerson
5   School of Medicine, Queen's University, Kingston, Ontario, Canada
,
Sarah McKnight
2   Department of Pediatrics, Queen's University, Kingston, Ontario, Canada
,
Susan B. Brogly
6   Department of Surgery, Queen's University, Kingston, Ontario, Canada
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Abstract

Objective The practice of rooming-in for opioid-dependent infants was introduced as the standard of care at our hospital following a pilot study which demonstrated that such infants had shorter lengths of stay and were less likely to require pharmacological treatment. We sought to determine whether these benefits have continued, and whether outcomes support continuing to use rooming-in as standard care.

Study Design Opioid-dependent infants delivered at 36 weeks gestation or later between January 1, 2015, and December 31, 2019, were eligible for rooming-in. Charts were reviewed and data were extracted regarding maternal and infant conditions, whether neonatal pharmacological treatment was required, and total length of hospital stay. Outcomes were compared with two historical groups reported in a previous pilot study: 24 healthy near-term opioid-dependent newborns who were admitted directly to the neonatal intensive care unit (NICU) prior to the introduction of rooming-in (May 1, 2012–May 31, 2013), and 20 similar opioid-dependent infants who were the first to room-in at our hospital (September 1, 2013–September 30, 2014).

Results Only 3.5% of 57 infants who roomed-in during the 5-year study period required pharmacological treatment, compared with 15% who roomed-in during the first year of the program's introduction and 83.3% who had been admitted directly to the NICU. The median length of stay remained 5 days for infants rooming-in, compared with 24 days for opioid-dependent infants in the cohort admitted to the NICU.

Conclusion Early observations of the benefits of rooming-in on neonatal outcomes were sustained. Infants allowed to room-in were significantly less likely to require initiation of pharmacotherapy and a prolonged hospital stay than similar infants prior to the implementation of rooming-in as standard care. A large proportion of the infants who might have benefited from rooming-in required admission to the NICU for reasons other than neonatal abstinence syndrome (NAS).

Key Points

  • Benefits of rooming-in for near-term opioid-dependent infants were sustained or increased.

  • Rooming-in is sustainable as standard care for these newborns.

  • Many infants required admission to NICU for reasons other than NAS.

Keywords

neonatal abstinence syndrome - opioid use disorder - nonpharmacological treatment - opioid-dependent infants


Publication History

Received: 03 June 2020

Accepted: 24 September 2020

Article published online:
17 November 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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