NEONATAL WITHDRAWAL FROM MATERNAL VOLATILE SUBSTANCE-ABUSE

Aim-To determine whether neonates born to mothers who are volatile sub stance abusers are at risk for an abstinence syndrome. Methods-A conse cutive sample of infants born to volatile substance abusing mothers wa s studied over four years, in a university affiliated medical centre w ith a variable mix of primary, secondary, and tertiary care patients. Infants were clinically scored with the Finnegan Neonatal Abstinence S coring System. Those who fulfilled a priori scoring criteria were trea ted with phenobarbital and scoring was continued. Results-There were 4 8 babies of whom 32 fulfilled the criteria for pharmacotherapy. All ei ght babies with the characteristic odour, and 15 of the 21 born to mot hers with that odour, fulfilled these criteria. The typical symptoms w ere excessive and high pitched cry, sleeplessness, hyperactive Moro re flex, tremor, hypotonia, and poor feeding. Mean age of onset of treatm ent was 27.1 hours and mean duration was 5.8 days. Treatment was judge d effective in 17 of 27, while benefit was borderline in three and abs ent in seven. Conclusions-It is suggested that there is an identifiabl e neonatal volatile substance abuse abstinence syndrome. The character istic chemical odour in the neonate or mother is a marker for its occu rrence, and phenobarbital treatment seems to be effective. The Finnega n Scoring System seems to be useful for grading its severity.