Neonatal Abstinence Syndrome (NAS) And Methamphetamine Use: A Review Of Finnegan’s As An Assessment Tool In The Women And Newborn Drug And Alcohol Service.

Angela O'Connor, Emma Harris, Dale Hamilton, Colleen Fisher, Mark Sachmann

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Abstract

Aim: Neonatal Abstinence Syndrome (NAS) is a syndrome that is diagnosed when the infant has been exposed predominately to opioids in pregnancy. Finnegan’s is a commonly used tool for health care professionals to assess the neonate for signs of NAS; however, it is not a validated tool for assessment of prenatal Methamphetamine (MA) exposure. There is currently no abstinence scoring tool uniquely for MA exposed neonates. The aim was to investigate the validity of using Finnegan’s as an assessment tool for non-opiate drug use and develop an evidence-based tool to assess and manage these high-risk infants in the perinatal period.

Methods: A prospective study was undertaken of 113 infants who were monitored for NAS between July 2015 and 2017. Women had the routine five -day inpatient stay as per current guidelines, and babies were monitored for signs of NAS using the current Finnegan’s tool. Data including maternal drug use, smoking, antidepressants, and polysubstance use were collected. Birth details, delivery type, nursery admission, and NAS scores were included and added into the Research Electronic Data Capture (REDCap) [1] database for analysis.

Results: Drug exposure was predominate to Methamphetamine (MA) with 70% of the women reporting heavy use which equated to using more than 10 points (1gram) of MA per week, mostly (79.5%) intravenously. Polysubstance use was reported as 17.9% for greater than 3 illicit substances, smoking rates were high with 87.5% of our women smoking throughout pregnancy. Twenty-six per cent (26%) of infants required resuscitation at birth and 41% of infants required admission to Special Care Nursery (SCN). Prematurity accounted for 24.5% of the sample. The mean NAS score was 2.99. Thirty-one infants (27.7 %) required a longer inpatient stay and 53 infants (47.3%) were slow to feed in the first 48 hours post birth. No infant required medication for NAS.

Conclusions: Finnegan's tool was not a useful tool in this population. We suggest a different model of care is needed for this high-risk group of infants.

Keywords: Methamphetamine use; Neonatal Abstinence syndrome; Non-pharmacological intervention; Pregnancy; Standardised diagnostic too
Original languageEnglish
Number of pages9
JournalInternational Journal of Nursing and Health Care Research
Volume5
Issue number6
DOIs
Publication statusPublished - Jul 2019

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