Measurement of neonatal abstinence syndrome: Evaluation of short forms

Hendrée E. Jones, PhD; Carl Seashore, MD; Elisabeth Johnson, FNP, PhD; Evette Horton, PhD; Kevin E. O’Grady, PhD; Kim Andringa, PhD

doi:10.5055/jom.2016.0308

Authors

Hendrée E. Jones, PhD
Carl Seashore, MD
Elisabeth Johnson, FNP, PhD
Evette Horton, PhD
Kevin E. O’Grady, PhD
Kim Andringa, PhD

DOI:

https://doi.org/10.5055/jom.2016.0308

Keywords:

neonatal abstinence syndrome, pregnancy, opioid use disorder, MOTHER NAS scale

Abstract

Objectives: 1) How well do the short forms previously developed from the Maternal Opioid Treatment: Human Experimental Research (MOTHER) neonatal abstinence syndrome (NAS) scale (MNS) discriminate between neonates untreated and treated for NAS? (2) Can a short form be developed that is superior to other short forms in discriminating between the two groups?

Design/participants: This secondary analysis study used data from 131 delivered neonates in the MOTHER study, a randomized controlled trial comparing neonatal and maternal outcomes in opioid-dependent pregnant women administered buprenorphine or methadone.

Setting: Comprehensive care was provided at seven university hospitals.

Outcome measures: A 19-item instrument measuring neonatal abstinence signs.

Results: A five-item index proved superior to the previous indices (ps < 0.01) and discriminated between the treated and untreated NAS groups as well as did the MNS total score (p=0.09).

Conclusions: A short form developed from the MNS shows promise as a possible screening measure.

Author Biographies

Hendrée E. Jones, PhD

Executive Director, UNC Horizons, and Professor, Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Adjunct Professor, Departments of Psychiatry and Obstetrics and Gynecology, School of Medicine, Johns Hopkins University, Baltimore, Maryland

Carl Seashore, MD

Associate Professor, Department of Pediatrics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina

Elisabeth Johnson, FNP, PhD

Clinical Assistant Professor, Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.

Evette Horton, PhD

Maternal and Child Therapist, UNC Horizons, Clinical Instructor, Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina

Kevin E. O’Grady, PhD

Associate Professor Emeritus, Department of Psychology, University of Maryland, College Park, College Park, Maryland

Kim Andringa, PhD

Director of Research and Evaluation, UNC Horizons, Research Instructor, Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina

References

Finnegan LP, Kaltenbach K: Neonatal abstinence syndrome. In Hoekelman RA, Friedman SB, Nelson NM, Seidel HM (eds.): Primary Pediatric Care. 2nd ed. St. Louis: Mosby, 1992: 1367-1378.

Jones HE, Kaltenbach K, Heil SH, et al: Neonatal abstinence syndrome after methadone or buprenorphine exposure. N Engl J Med. 2010; 363(24): 2320-2331.

Finnegan LP, Connaughton JF Jr, Kron RE, et al: Neonatal abstinence syndrome: Assessment and management. Addict Dis. 1975; 2(1-2): 141-158.

Jones HE, Harrow C, O'Grady KE, et al: Neonatal abstinence scores in opioid-exposed and nonexposed neonates: A blinded comparison. J Opioid Manag. 2010; 6(6): 409-413.

Jones HE, Fischer G, Heil SH, et al: Maternal Opioid Treatment: Human Experimental Research (MOTHER): Approach, issues, and lessons learned. Addiction. 2012; 107(suppl 1): 28-35

Weaver MF, Jones HE, Wunsch MJ: Alcohol and other drug use during pregnancy: Management of the mother and child. In Ries RK, Fiellin SC, Miller DA (eds.): The ASAM Principles of Addiction Medicine. 5th ed. Philadelphia: Lippincott Williams & Wilkins, 2014: 1111-1124.

DeLong ER, DeLong DM, Clarke-Pearson DL: Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. Biometrics. 1988; 44(3): 837-845.

Gaalema DE, Heil SH, Badger GJ, et al: Time to initiation of treatment for neonatal abstinence syndrome in neonates exposed in utero to buprenorphine or methadone. Drug Alcohol Depend. 2013; 133(1): 266-269.