NEONATAL WITHDRAWAL SYNDROME - ASSOCIATED DRUGS AND PHARMACOLOGICAL MANAGEMENT

Use of addicting drugs among women during pregnancy exposes newborns t o potentially serious disorders. A group of symptoms referred to as ne onatal withdrawal syndrome (NWS) may occur in infants born to mothers addicted to certain drugs because, at birth, the infants suddenly are cut off from the drug supply. Classes of drugs that cause NWS are thos e that produce addiction in adults, including the opioids (heroin, met hadone, morphine), barbiturates, alcohol, and benzodiazepines. Many of the manifestations of NWS occur regardless of the class of drug, incl uding irritability, hyperactivity, abnormal sleep pattern, high-pitche d cry, tremor, vomiting, diarrhea, weight loss, and failure to gain we ight. The fact that these symptoms are nonspecific makes it difficult to identify NWS unless it is specifically looked for. The onset, durat ion, and severity of the disorder differ based on such factors as the addictive drug used, time and amount of mother's last dose, and rate o f elimination of the drug from the newborn. Pharmacologic intervention may be required to control severe symptoms and signs. The most common drugs used to modify withdrawal are phenobarbital, paregoric, chlorpr omazine, and diazepam. Treatment is complicated by conflicting informa tion on the effectiveness of various agents.