Neonatal opioid withdrawal syndrome (NOWS) is a significant public health concern with associated prolonged neonatal hospitalizations. While the Finnegan Neonatal Abstinence Scoring Tool (FNAST) is validated for use in full-term in-utero opioid exposed infants, there is no validated tool for preterm opioid-exposed or critically ill infants with iatrogenic opioid withdrawal. We aimed to evaluate the concordance of a novel NICU Withdrawal Assessment Scale (NWAS) designed for this critically ill infant cohort with the traditional FNAST. Fifteen critically ill infants in the NICU with iatrogenic opioid withdrawal were dual assessed with the NWAS and FNAST. Correlation between the scores was determined using Spearman’s correlation and linear regression. The mean gestational age of the cohort was 31.9 weeks (SD 6.0) with a range of neonatal diagnoses, and average length of opioid treatment of 35.4 days (SD 17.9). A total of 93 occurrences of simultaneous NWAS and FNAST scores were obtained. The Spearman correlation coefficient was Rho=0.77 (95% Cl: 0.67 - 0.84, p-value <.0001) indicating a strong, positive linear correlation. Linear regression indicated as positive correlation with magnitude of the scores R = 0.77, y (FNAST score) = 0.85 + 1.49 x (NWAS score), p-value <0.0001. Further examination of the association with management with the NWAS tool and clinical outcomes can inform future creation of evidence-based guidelines for the treatment of NOWS in premature and critically ill infants.
Herning et al. (Thu,) studied this question.
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