Table 1 Studies of tools to assess neonatal abstinence syndrome
From: Review of the assessment and management of neonatal abstinence syndrome
Reference | Index vs. reference group(s) | Scale | Primary results |
|---|---|---|---|
Finnegan, 1975[29] | 37 infants assessed with NASS vs. 37 infants born prior to development of NASS | Neonatal Narcotic Abstinence Scoring System | Mean inter-rater reliability coefficient: 0.82 (0.75–0.96) |
Exposure methadone and heroin | 20 items, weighted on pathologic severity | Management of NAS without drug Rx: 30% vs. 46% | |
LOS: 6 days vs. 8 days | |||
Total Rx days decreased by 25% | |||
Lipsitz, 1975[31] | 41 infants evaluated by 2 pediatric residents, placed in 5 groups, one group which was opioid exposed | Narcotic Withdrawal Score | Only the infants exposed to opioids had scores ≥ 5; concluded that a score > 4 suggests a clinical threshold for Rx |
Exposure methadone and heroin | 11 items, scored 0–3 based on severity | ||
Green, 1981[32] | Infants exposed to methadone or heroin(n = 50) | Neonatal Narcotic Withdrawal Index | Inter-rater reliability coefficient: 0.771* |
Control infants (n = 40) | 7 items, scored 0–2 based on severity | Mean NAS score on day 2 of life: 1.57 vs. 3.08* | |
7th item is “other” and includes 12 other symptoms | |||
Zahorodny, 1998[33] | Group A: opioid-exposed infants with NAS (n = 30) | Neonatal Withdrawal Inventory | Group A: inter-rater reliability coefficient: 0.89–0.98 |
Group B: opioid infants with NAS (n = 12) and nonopioid-exposed controls (n = 13) | 8 items given predetermined weights | Group B: sensitivity and specificity for NAS diagnosis: 100%, 100% | |
Group C: opioid-exposed infants with NAS (n = 25) | Group C: sensitivity and specificity for Rx threshold vs. the NASS: 100%, 100% | ||
Jones, 2010[3] | 131 opioid-exposed infants, scored using the same scale | MOTHER NAS scale (modified Finnegan) | Intraclass correlation coefficient > 0.94 |
Exposure methadone or buprenorphine |