Objective: To determine if treatment with a 5-HT3 antagonist (ondansetron) reduces need for opioid therapy in infants at risk for neonatal opioid withdrawal syndrome (NOWS).
Study Design: A multicenter, randomized, placebo controlled, double blind clinical trial of ninety (90) infants. The intervention arms were intravenous ondansetron or placebo during labor followed by a daily dose of ondansetron or placebo in infants for five days.
Results: Twenty-two (49%) ondansetron-treated and 26 (63%) placebo-treated infants required pharmacologic treatment (p > 0.05). The Finnegan score was lower in the ondansetron-treated group (4.6 vs. 5.6, p = 0.02). A non-significant trend was noted for the duration of hospitalization. There was no difference in need for phenobarbital or clonidine therapy, or total dose of morphine in the first 15 days of NOWS treatment.
Conclusions: Ondansetron treatment reduced the severity of NOWS symptoms; and there was an indication that it could reduce the length of stay.
Clinical Trial Registration: Clinicaltrials.gov NCT01965704.
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http://dx.doi.org/10.1038/s41372-022-01487-2 | DOI Listing |
Child Abuse Negl
January 2025
Social Science Research Institute, Pennsylvania State University, United States of America. Electronic address:
Background: Neonatal abstinence syndrome (NAS), or withdrawal from prenatal opioid exposure at birth, can trigger a referral to child protective services (CPS). However, there is some evidence of selection into NAS diagnosis because NAS screening is not universal. Such referrals may protect the infant, help connect the mother to services, or cause harm.
View Article and Find Full Text PDFBMJ Open
December 2024
Department of Anesthesiology, Peking University First Hospital, Beijing, China
Objective: To investigate the impact of dexmedetomidine-ropivacaine combination versus sufentanil-ropivacaine combination for epidural labour analgesia on neonatal and maternal outcomes and test the feasibility of a future large, randomised trial.
Design: A randomised, double-blind, pilot clinical trial from 16 March 2023 to 15 June 2023.
Setting: A tertiary-care hospital in Beijing, China.
Endocr Metab Immune Disord Drug Targets
January 2025
Department of Pediatrics, El Menshawy General Hospital, Tanta, Egypt.
Neonates exhibit pain responses characterized by various endocrinal changes, including alterations in cortisone and oxytocin serum levels, as well as physiological and emotional reactions. The administration of neonatal pain management leads to the normalization of endocrine hormones, including cortisone and oxytocin, which are affected by the presence of neonatal pain. Diagnosing neonatal pain is complex; however, effective management is essential.
View Article and Find Full Text PDFJ Addict Med
December 2024
From the Department of Pediatrics, UMass Chan School of Medicine, Worcester, MA (MGP, AE); Slone Epidemiology Center, Boston University School of Medicine, Boston, MA (FR, CP, SK, MC); Divisions of General Academic Pediatrics and Newborn Medicine, Mass General for Children, Boston, MA (DMS); Department of Pediatrics, Washington University School of Medicine, St Louis, MO (BC, HF, EC); Department of Pediatrics, UMass Chan Medical School-Baystate, Worcester, MA (KH); Department of Biostatistics, Boston University School of Public Health, Boston, MA (TH); and Department of Pediatrics, Boston Medical Center, Boston, MA (EMW).
Objectives: Sudden unexpected infant death (SUID) occurs disproportionately among opioid exposed newborns (OENs) compared to those unexposed. The extent that primary caregivers of OENs adhere to SUID-reducing infant care practices is unknown. We examined rates of SUID-reducing practices (smoking cessation, breastfeeding, and safe sleep [supine sleep, room-sharing not bed-sharing, nonuse of soft bedding or objects]) in a pilot sample of caregivers of OENs.
View Article and Find Full Text PDFNagoya J Med Sci
November 2024
Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Studies have suggested that the administration of epidural analgesia (Epi) and oxytocin (OT) during labor affects offspring outcomes. However, the effects of their combined use remain unclear. This article aimed to review the outcomes of offspring exposed to Epi and OT, identify research gaps, and discuss future research directions.
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