The prevalence of opioid use during pregnancy has dramatically increased in the past decade. More women are abusing prescription opioids, using illegal opioids and opioid substitution therapy then before. These drugs are associated with numerous obstetrical complications including intrauterine growth restriction, placental abruption, preterm delivery, stillbirth, and maternal death. Neonatal complications are also prevalent, such as low birthweight as well as neonatal abstinence syndrome (NAS). NAS is a complex disorder that primarily involves the dysfunction of the central and autonomic nervous systems, and the gastrointestinal system. Clinical manifestation of NAS vary, ranging from mild tremors and irritability to fever, excessive weight loss, and seizures. There has been a substantial amount of research done on NAS over the years. However, there still exists a lack of research on how NAS is defined, measured, and managed. Hospitals and clinics should have appropriate protocols for treatment of both the mother and infant. The growing prevalence of NAS reflects an issue of a much larger epidemic, one that suggests an increase in the use of opioids, lack of maternal education, and limited resources for mothers on drugs. The purpose of this review is to summarize the current literature on neonatal abstinence syndrome, including identification, epidemiology, clinical features and outcomes, and existing treatment. Additionally, this review aims to develop a possible protocol to guide treatment, educate the parent, and aid in the prevention of NAS.
