Gabapentin Use for Hospitalized Neonates

ABSTRACT BACKGROUND Despite some clinician advocacy for the use of gabapentin to treat neonatal irritability of presumed neurologic origin, the extent of gabapentin administration to hospitalized neonates is unknown. We aimed to identify trends in gabapentin utilization among infants hospitalized in neonatal intensive care units (NICUs) across the United States (US) and to evaluate the associations between clinical diagnoses and gabapentin treatment. METHODS We analyzed NICU admitted neonates within the 2005-2016 Pediatric Health Information System to measure treatment timing, duration, and frequency. We used a modified Poisson regression with a robust between-cluster variance estimator to calculate a probability (adjusted relative risk) for gabapentin administration. RESULTS Of 278,403 neonates, 374 were administered gabapentin treatment (0.13%). The median treatment duration was 16 days (25th-75th%: 8-40). Gabapentin use increased from 0% in 2005 to 0.39% in 2016. Treatment was prescribed to neonates at 31 of 48 studied hospitals; 73% of total treated infants localized to 5 NICUs. Term (0.16%) and ≤28-weeks gestation preterm infants (0.22%) were most likely to receive gabapentin. Varying by gestational age, a diagnosis of chromosomal abnormalities, severe bronchopulmonary dysplasia (BPD), hemorrhagic stroke, and neonatal abstinence syndrome (NAS) were associated with higher treatment with gabapentin. The majority (88.8%) of treated infants did not have a seizure diagnosis. CONCLUSION Gabapentin use in US NICUs increased in recent years and varies markedly between institutions. Term infants, ≤28-weeks gestation preterm infants, and neonates with chronic genetic, neurologic, and gastrointestinal diagnoses were more likely to receive gabapentin.