Prenatal Substance Abuse: a 1-Year Single-Center Experience at a Tertiary Neonatal Intensive Care Unit

Abstract

Objective: Eight newborns diagnosed with prenatal substance abuse were evaluated for the clinical course of neonatal abstinence syndrome depending on the type of substances used by their mothers during pregnancy. Material and Methods: A retrospective study of neonates with prenatal substance abuse admitted to our tertiary care university hospital’s Neonatal Intensive Care Unit (NICU) was conducted between February 2022 and March 2023. Demographic data, withdrawal symptoms, need for pharmacological treatment, and duration of hospitalization were collected. Newborns exposed to substances were divided into two groups: opioid and non-opioid (methamphetamine, Bonsai, marijuana). Results: Eight infants were included in the study. Four cases (50%) were in the group exposed to opioids. Pregnant users of opioids were older (28±6.73) than non-opioid substance users (21±4.83). The mean birth weight of newborns exposed to opioids (2541 g) was lower than that of the non-opioid group (3020 g). The average length of hospital stay was longer in the opioid group (34 days) compared to the non-opioid group (10 days). All newborns exposed to substances were born preterm (<37 gestational weeks). Withdrawal symptoms were observed in all cases in the opioid group and three cases in the non-opioid group to varying degrees. Medical treatment was required in three out of the seven cases with withdrawal symptoms. All patients requiring treatment were in the opioid group. All infants were discharged in good health. Conclusion: Substance exposure during the prenatal period is a significant cause of preterm birth in neonates. Many of these substances can cause varying degrees of withdrawal syndrome in newborns. Replacement therapies used during pregnancy containing heroin and naloxone can lead to a more severe, prolonged, and treatment-requiring neonatal withdrawal syndrome than other substances. In cases where morphine and methadone are unavailable, the symptoms of withdrawal syndrome can be managed with phenobarbital. It is crucial to monitor all newborns with prenatal exposure to substances early because it allows for appropriate intervention and treatment.