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Heroin Addiction and Related Clinical Problems: 2023, 25, N1 (pages: 21 - 27)

Neonatal Abstinence Syndrome in Vojvodina, Serbia: Infant and Maternal Characteristics

Mijatović Jovin V., Vejnović A., Knezović G., Pavlović V., Vejnović A.-M., and Dickov I.

Summary: Background: Maternal use of psychotropic agents leads to fetal exposure and development of neonatal abstinence syndrome (NAS) in the infant after sudden withdrawal of these drugs in the postnatal period. Aim: To analyze the characteristics /of infants diagnosed/ with NAS and together with their mothers in the main province of Serbia. Methods: This retrospective-longitudinal study, including data regarding infants diagnosed with NAS and their mothers from 2012 to 2016, was conducted in Vojvodina, Serbia. Results: A total of 41 cases of NAS were registered. The highest rate of NAS/1000 live births was in 2016 (0.52). The average age of the mothers was 29±5 years. The average number of childbirths per mother was 2.03±1.21. More than half of the mothers gave birth vaginally (58.54%). Methadone (45.00%) was the most prescribed opioid, while heroin was the most frequently used illegal opioid (30%). Most of the NAS population (87.80%) went to term. Perinatal asphyxia was diagnosed in 14.64% of the infants. Seven (17.07%) newborns were small for gestational age. The highest (≥17) as well as the lowest (≤7) Finnegan score was registered in the same percentage of the infants (21.95%). A statistically significant difference was found in NAS occurrence between mothers who used heroin during pregnancy and those who used methadone (p = 0.0002). Nine (21.95%) of the NAS patients did not receive pharmacological therapy. Median length of stay in the hospital for patients with NAS was 27±13 days. Conclusions: Understanding of maternal and infant characteristics in NAS has important implication for primary, secondary, and tertiary prevention.