A New Scoring System for the Assessment of Neonatal Abstinence Syndrome

Prabhakar Kocherlakota; Edward C. Qian; Vishwas C. Patel; Cosmina Mandru; Rolando E. Vilar; Gad Alpan; Edmund F. La Gamma

doi:10.1055/s-0039-3400310

American Journal of Perinatology, Table of Contents

Am J Perinatol 2020; 37(03): 333-340
DOI: 10.1055/s-0039-3400310

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

A New Scoring System for the Assessment of Neonatal Abstinence Syndrome

Prabhakar Kocherlakota

¹Department of Pediatrics, Elaine Kaplan NICU, Montefiore St. Luke's Cornwall Hospital, Newburgh, New York

²Department of Pediatrics, The Regional Neonatal Intensive Care Unit, Maria Ferrari Children's Hospital at Westchester Medical Center, New York Medical College, Valhalla, New York

,

Edward C. Qian

¹Department of Pediatrics, Elaine Kaplan NICU, Montefiore St. Luke's Cornwall Hospital, Newburgh, New York

,

Vishwas C. Patel

¹Department of Pediatrics, Elaine Kaplan NICU, Montefiore St. Luke's Cornwall Hospital, Newburgh, New York

,

Cosmina Mandru

²Department of Pediatrics, The Regional Neonatal Intensive Care Unit, Maria Ferrari Children's Hospital at Westchester Medical Center, New York Medical College, Valhalla, New York

,

Rolando E. Vilar

¹Department of Pediatrics, Elaine Kaplan NICU, Montefiore St. Luke's Cornwall Hospital, Newburgh, New York

²Department of Pediatrics, The Regional Neonatal Intensive Care Unit, Maria Ferrari Children's Hospital at Westchester Medical Center, New York Medical College, Valhalla, New York

,

Gad Alpan

²Department of Pediatrics, The Regional Neonatal Intensive Care Unit, Maria Ferrari Children's Hospital at Westchester Medical Center, New York Medical College, Valhalla, New York

,

Edmund F. La Gamma

¹Department of Pediatrics, Elaine Kaplan NICU, Montefiore St. Luke's Cornwall Hospital, Newburgh, New York

²Department of Pediatrics, The Regional Neonatal Intensive Care Unit, Maria Ferrari Children's Hospital at Westchester Medical Center, New York Medical College, Valhalla, New York

› Author Affiliations

Abstract

Objective This study aimed to evaluate the concordance of a new scoring system for neonatal abstinence syndrome (NAS) and NAS scores to the traditional Modified Finnegan Neonatal Abstinence Scoring Tool (M-FNAST) score. The NAS score is based on the physiology of withdrawal, with equal emphasis on behavior, and neurological signs.

Study Design The NAS scores for a control group of 202 healthy, term neonates were compared with those for 45 term neonates with NAS. The NAS and M-FNAST scores obtained simultaneously in 45 term neonates with NAS were compared using correlation, linear regression, and receiver operating characteristic curve analysis to determine the validity, reliability, and specificity of the NAS scores.

Results The association between the NAS and M-FNAST scores was high (Spearman's correlation, 83%; linear regression, 83%), with an area under the curve of the NAS score of 1.00 (p < 0.01). A cut-off NAS score ≥4 identified NAS neonates with a sensitivity of 100% and specificity of 96%. The values of intraclass correlation, interrater agreement, and Cronbach's α were 0.63, 0.88, and 0.63, respectively.

Conclusion The new NAS scoring system is valid, reliable, physiologically based, and correlates closely with the M-FNAST score. The NAS scores may require further validation before its use in clinical practice.

Keywords

neonatal abstinence syndrome - NAS scores - withdrawal - physiological

Full Text

References

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