A New Option for Management of Neonatal Abstinence Syndrome | New England Journal of Medicine

In the U.S., the use of opioid pain relievers during pregnancy continues to rise. This has contributed to an increased incidence of neonatal abstinence syndrome (NAS), which occurs in approximately 6 per 1000 hospital births and results in long hospital stays and high healthcare costs. While oral morphine is the predominant agent used to treat NAS, in adults, buprenorphine produces less cardiopulmonary depression compared to other long-acting opioids.

These investigators randomized 63 term infants with signs and symptoms of NAS after intrauterine exposure to opioids to receive sublingual buprenorphine (titrated to a maximum dose of 60 µg/kg/day) or oral morphine (titrated to a maximum dose of 1.2 mg/kg/day). Infants treated with buprenorphine, compared to those treated with morphine, had significantly shorter courses of treatment (median, 15 vs. 28 days) and hospital stays (median, 21 vs. 33 days). Use of supplemental phenobarbital and rates of adverse events were similar in the two groups.