Fetal gastric area ratio to predict severe neonatal opioid withdrawal syndrome

Abstract

Objective

Neonatal opioid withdrawal syndrome (NOWS) can occur in newborns exposed to opioids in pregnancy. Opioids delay gastric emptying and inhibit gastric motility in adults, but little is known about their effect in the fetus. We sought to assess gastric area ratio (GAR) in opioid-exposed fetuses.

Study Design

Retrospective cohort study including opioid-exposed maternal-neonatal dyads between 2007–2017. Primary outcome: severe NOWS (three consecutive Finnegan scores ≥8 or three scores totaling ≥24 within 96 h of life). GAR: (gastric area)/(transverse abdominal area) × 100. Data analysis was by descriptive, parametric, and non-parametric tests.

Results

Forty-nine maternal-neonatal dyads were included, 67% (n = 33) with severe NOWS. GAR <95th percentile for gestational age was seen in 80% of neonates (n = 39). However, GAR was not different between groups (p = .90) and did not predict severe NOWS.

Conclusion

Fetal GAR was <95th percentile in 80% of opioid-exposed neonates. However, fetal GAR may not predict NOWS treatment.

Keywords:

• Opioids
• gastric area
• neonatal opioid withdrawal syndrome
• opioid-exposed fetus
• opioids in pregnancy

Acknowledgments

Presented as an oral presentation at the 2018 American Institute of Ultrasound in Medicine (AIUM) Convention, March 26, 2018, New York, NY.

Disclosure statement

The authors report no conflicts of interest.

Data availability statement

The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.