Academic pediatrics · 2026
Impact of Eat, Sleep, Console Versus Finnegan Neonatal Abstinence Scoring System on Neonatal Outcomes: A Meta-Analysis.
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Qu Lianhao, Rhind Avery, Sefton Sabrina, Ybema Seth, Goyal Medha, Ashraf Rizwana, Secord-Gilbert Margaret, Wong Michael, D'Souza Rohan
Аннотация
BACKGROUND: There are limited high-quality syntheses supporting the use of Eat, Sleep, Console (ESC) approach over Finnegan Neonatal Abstinence Scoring System (FNASS) for Neonatal abstinence syndrome (NAS).
OBJECTIVE: To compare outcomes with ESC versus FNASS DATA SOURCES: Medline, EMBASE, PsycINFO, Web of Science, and CINAHL until March 2025 STUDY ELIGIBILITY CRITERIA: English-language articles comparing outcomes with ESC and FNASS.
APPRAISAL AND SYNTHESIS METHODS: Random effects meta-analysis to calculate risk ratios (RR), absolute risk reduction (ARR), and mean difference (MD) with 95% confidence intervals (95%CI) and certainty of evidence (CoE) using the GRADE approach.
RESULTS: We identified 30 observational studies and 1 randomized controlled trial (RCT). Based on meta-analysis of observational studies, ESC may be associated with reduced need for pharmacological treatment [n=6098; RR 0.51, 95%CI, 0.41-0.63, ARR 23.9%, low CoE]. ESC may also be associated (very low CoE) with shorter length of hospital stay [n=5841, MD -4.33; 95%CI -5.66 to -2.99], fewer neonatal intensive care unit admissions [n=2112; RR 0.69, 95%CI 0.51-0.93, ARR 10.1%], decreased hospital costs [n=546; MD -13,341, 95%CI -15,993 to -10,690], shorter duration of pharmacological treatment [n=3021; MD -4.97 days, 95%CI -5.68 to -4.26] and higher 30-day readmission risk [n=3390; RR 1.43, 95%CI 1.02-1.99, ARR 1.2%].
LIMITATIONS: Risk-of-bias; Heterogeneity in outcomes; low-to-very-low CoE.
CONCLUSIONS: Based on low CoE largely from observational studies, ESC may reduce treatment duration, hospital stay, and hospital costs. Well-powered RCTs assessing a range of patient important outcomes are required to confirm the optimal assessment approach for NAS outcomes.
SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42024530639.
OBJECTIVE: To compare outcomes with ESC versus FNASS DATA SOURCES: Medline, EMBASE, PsycINFO, Web of Science, and CINAHL until March 2025 STUDY ELIGIBILITY CRITERIA: English-language articles comparing outcomes with ESC and FNASS.
APPRAISAL AND SYNTHESIS METHODS: Random effects meta-analysis to calculate risk ratios (RR), absolute risk reduction (ARR), and mean difference (MD) with 95% confidence intervals (95%CI) and certainty of evidence (CoE) using the GRADE approach.
RESULTS: We identified 30 observational studies and 1 randomized controlled trial (RCT). Based on meta-analysis of observational studies, ESC may be associated with reduced need for pharmacological treatment [n=6098; RR 0.51, 95%CI, 0.41-0.63, ARR 23.9%, low CoE]. ESC may also be associated (very low CoE) with shorter length of hospital stay [n=5841, MD -4.33; 95%CI -5.66 to -2.99], fewer neonatal intensive care unit admissions [n=2112; RR 0.69, 95%CI 0.51-0.93, ARR 10.1%], decreased hospital costs [n=546; MD -13,341, 95%CI -15,993 to -10,690], shorter duration of pharmacological treatment [n=3021; MD -4.97 days, 95%CI -5.68 to -4.26] and higher 30-day readmission risk [n=3390; RR 1.43, 95%CI 1.02-1.99, ARR 1.2%].
LIMITATIONS: Risk-of-bias; Heterogeneity in outcomes; low-to-very-low CoE.
CONCLUSIONS: Based on low CoE largely from observational studies, ESC may reduce treatment duration, hospital stay, and hospital costs. Well-powered RCTs assessing a range of patient important outcomes are required to confirm the optimal assessment approach for NAS outcomes.
SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42024530639.