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Finnegan neonatal abstinence scoring system: normal values for first 3 days and weeks 5–6 in non-addicted infants


Zimmermann-Baer, U; Nötzli, U; Rentsch, K; Bucher, H U (2010). Finnegan neonatal abstinence scoring system: normal values for first 3 days and weeks 5–6 in non-addicted infants. Addiction, 105(3):524-528.

Abstract

ABSTRACT
Objective The neonatal abstinence scoring system proposed by Finnegan is used widely in neonatal units to initiate
and to guide therapy in babies of opiate-dependent mothers. The purpose of this study was to assess the variability of
the scores in newborns and infants not exposed to opiates during the first 3 days of life and during 3 consecutive days in weeks 5 or 6. Patients and methods Healthy neonates born after 34 completed weeks of gestation, whose parents
denied opiate consumption and gave informed consent, were included in this observational study. Infants with signs or
symptoms of disease or with feeding problemswere excluded. Amodified scoring systemwas used every 8 hours during
72 hours by trained nurses; 102 neonates were observed for the first 3 days of life and 26 neonates in weeks 5–6. A
meconium sample and a urine sample atweeks 5–6were stored from all infants to be analysed for drugswhen the baby
scored high. Given a non-Gaussian distribution the scores were represented as percentiles. Results During the first 3
days of lifemedian scores remained stable at 2 but the variability increased, with the 95th percentile rising from 5.5 on
day 1 to 7 on day 2. Atweeks 5–6 median valueswere higher during daytime (50th percentile = 5, 95th percentile = 8)
than night-time (50th percentile = 2, 95th percentile = 6, P = 0.02). Conclusion Scores increase from days 1–3 to
weeks 5–6 and show day–night cycles with 5–6 weeks. Values above 8 can be considered pathological. This data may
help to raise suspicion of narcotic withdrawal and to guide therapy.

Abstract

ABSTRACT
Objective The neonatal abstinence scoring system proposed by Finnegan is used widely in neonatal units to initiate
and to guide therapy in babies of opiate-dependent mothers. The purpose of this study was to assess the variability of
the scores in newborns and infants not exposed to opiates during the first 3 days of life and during 3 consecutive days in weeks 5 or 6. Patients and methods Healthy neonates born after 34 completed weeks of gestation, whose parents
denied opiate consumption and gave informed consent, were included in this observational study. Infants with signs or
symptoms of disease or with feeding problemswere excluded. Amodified scoring systemwas used every 8 hours during
72 hours by trained nurses; 102 neonates were observed for the first 3 days of life and 26 neonates in weeks 5–6. A
meconium sample and a urine sample atweeks 5–6were stored from all infants to be analysed for drugswhen the baby
scored high. Given a non-Gaussian distribution the scores were represented as percentiles. Results During the first 3
days of lifemedian scores remained stable at 2 but the variability increased, with the 95th percentile rising from 5.5 on
day 1 to 7 on day 2. Atweeks 5–6 median valueswere higher during daytime (50th percentile = 5, 95th percentile = 8)
than night-time (50th percentile = 2, 95th percentile = 6, P = 0.02). Conclusion Scores increase from days 1–3 to
weeks 5–6 and show day–night cycles with 5–6 weeks. Values above 8 can be considered pathological. This data may
help to raise suspicion of narcotic withdrawal and to guide therapy.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Neonatology
04 Faculty of Medicine > University Hospital Zurich > Institute of Clinical Chemistry
Dewey Decimal Classification:610 Medicine & health
540 Chemistry
Language:English
Date:March 2010
Deposited On:20 May 2010 12:17
Last Modified:26 Jan 2017 08:47
Publisher:Wiley-Blackwell
ISSN:0965-2140
Publisher DOI:https://doi.org/10.1111/j.1360-0443.2009.02802.x
PubMed ID:20402996

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