infants born to heroin-dependent or methadone-dependent mothers have a high incidence of neonatal abstinence reaction (also less potent opioids have also been identified as causing neonatal abstinence syndrome (NAS))
possible clinical features of NAS are non-specific and include tremor, unrest, tachypnoea, hypertonicity, vomiting,abnormal crying, yawning, sneezing, diarrhoea, fever, poor feeding - in very severe cases of NAS convulsions may occur
onset of clinical NAS symptoms depends on which opioids the pregnant opioid-dependent woman received or consumed
for example
heroin, the withdrawal syndrome in the neonate occurs during the first 24 h
with methadone NAS does not develop until after 48 h
effectiveness and safety of opiate treatment in newborn infants has been published recently in Cochrane Review (2)
opiates are concluded as preferred initial therapy for NAS, especially for infants of mothers using opioids during pregnancy
Reference:
(1) Ebner N et al. Management of neonatal abstinence syndrome in neonates born to opioid maintained women Drug and Alcohol Dependence 2007;87(2-3);16: 131-138.
(2) Osborn A et al. Opiate treatment for opiate withdrawal in newborn infants (Review).Cochrane Library 2005, Issue 2.
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