Risk factors for neonatal abstinence syndrome in infants born to mothers using psychotropic medications: A cohort study.

BACKGROUND

Neonatal abstinence syndrome (NAS) encompasses symptoms that are observed in neonates exposed to psychotropic drugs in utero. Although NAS associated with opioid exposure has been well studied, the risk of NAS related to maternal psychotropic medication use remains underexplored. The aim of this study was to examine the association between maternal psychotropic medication use and NAS incidence in neonates born to mothers with psychiatric disorders.

METHODS

A retrospective cohort study was conducted at the Kagoshima University Hospital between January 2021 and December 2023. Maternal and neonatal data, including psychotropic medication exposure, were collected. NAS was assessed using the Finnegan score extracted from medical records.

RESULTS

Among the 132 neonates studied, 27 (20.5 %) developed NAS. Significant predictors of NAS included maternal use of antipsychotics, anxiolytics, and hypnotics. NAS severity showed weak positive correlations with the number and index of psychotropic medications. The most accurate predictive model combined the psychotropic medication index with the 1-min Apgar score (area under the receiver operating characteristic curve = 0.860).

CONCLUSIONS

Maternal psychotropic medication use is significantly associated with NAS development. Although the predictive model showed promising accuracy, it is important to interpret these findings with caution due to the retrospective design of the study and the relatively mild NAS severity. Integrating pharmacological and clinical data may assist in identifying neonates at risk; however, further validation is warranted.