Understanding the effects of prematurity on clinical manifestations of neonatal abstinence syndrome: A narrative literature review

Abstract Introduction Neonatal abstinence syndrome is a collection of postnatal withdrawal symptoms caused by in-utero exposure to opioids. Despite the high association with prematurity, there is a lack of research informing proper identification of neonatal abstinence syndrome in preterm newborns. Objective To delineate contrast in clinical manifestations of neonatal abstinence syndrome between preterm and full-term newborns, and to explain how common morbidities of prematurity may be responsible for the identified differences. Methods A literature search was undertaken in PubMed, Google Scholar, and PsychInfo. Results Five research studies, discussing neonatal abstinence syndrome symptomatology related to gestational age or morbidities of prematurity, were reviewed. Conclusion Preterm newborns with neonatal abstinence syndrome present in ways that are distinct from full-term newborns and untraceable by diagnostic assessment tool currently available. A better understanding of pathophysiology of neonatal abstinence syndrome in the context of prematurity is necessary in order to improve assessment and intervention outcomes.