Comparing Neonatal Abstinence Syndrome and its Management in Babies Prenatally Exposed to Opioids and Methamphetamines

Background The increasing prevalence of methamphetamine use during pregnancy has raised concerns about its impact on neonatal outcomes, including neonatal abstinence syndrome (NAS). This retrospective cohort study aimed to examine the severity of NAS and associated clinical outcomes in neonates based on the type of prenatal substance exposure (opioids, methamphetamines, or a combination). Material and Methods The study population included 80 term neonates born to mothers with documented substance use, stratified into three cohorts: opioid-only exposure, stimulant-only exposure, and combined opioid and stimulant exposure. Data on birth weight, gestational age, gender, route of delivery, length of hospital stay, and treatment requirements were extracted from medical records. Results Significant differences were observed in birth weight, with infants in the opioid-only group being heavier compared to the other two groups. The rates of small for gestational age (SGA) were 0%, 12.5%, and 21.4% in the opioid, methamphetamine, and Opioid + Methamphetamine groups, respectively. However, gestational age and the need for cesarean delivery did not differ significantly across the groups. Regarding treatment requirements, there were no statistically significant differences among the groups in the need for pharmacological or non-pharmacological interventions, nor in the duration of hospitalization. Conclusions Contrary to previous findings, this study suggests that neonates prenatally exposed to methamphetamines may exhibit NAS severity and treatment requirements comparable to those exposed to opioids. These findings challenge the long-held notion that opioid withdrawal universally eclipses the severity of methamphetamine withdrawal in newborns. Further research is needed to elucidate the potential mediating variables that may contribute to the observed equivalency in NAS susceptibility across different drug classes.