Neonatal abstinence syndrome in three days old female infant from a HIV infected mother with twelve years of using methadone

Abstract

Neonatal Abstinence Syndrome (NAS) is a group of symptoms that occur in a newborn as a result of the sudden discontinuation of fetal exposure to substances that were abused by the mother during pregnancy period. NAS is a rare case in Indonesia; however the incidence of NAS among foreign countries, namely England, Canada, and Western Australia, is increasing. The symptoms of NAS are very similar to other neonatal diseases, such as sepsis and hypoglycemia neonatal; therefore, the diagnosis approach of NAS should be done properly. This report described management of a rare case of NAS in three days old female infant from a HIV infected mother with 12 years of using methadone. A three days old female infant was hospitalized with symptoms of high pitch cry, fever, tremor, poor feeding and vomiting. She was very irritable, sweating, and had highly fluctuating body temperature. She also found with high respiration rate, and hypoglycemia. Her mother has been using methadone for 12 years. At the baseline, we found Neonatal Abstinence Syndromes (NAS) score was 18 based on Finnegan Neonatal Abstinence Severity Score (FNAS) score. According to the guideline, oral morphine was given as a definitive medication together with other supportive therapy. After four days of therapy, morphine dose was tapered and continued until ninth days of treatment. Patient was discharged at 14 days of hospitalization. In conclusion, this report presents a case of three days old female infant with severe NAS, based on FNAS score is 18. This patient was treated with morphine and revealed with good outcome. However, in the future, proper evaluation of growth and development should be done.

Keywords: Neonatal Abstinence Syndrome, methadone user mother, morphine therapy.

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