Ati Maternal Newborn Proctored
Assessment and Management of Newborn Complications
2023 Study Guide
- Neonatal substance withdrawal
Maternal substance use during pregnancy consists of any use of alcohol or drugs.
Intrauterine drug exposure can cause anomalies, neurobehavioral changes, and
evidence of withdrawal in the neonate.
These changes depend on the specific drug or combination of drugs used, dosage,
route of administration,metabolism and excretion by the mother and fetus, timing
of drug exposure, and length of drug exposure. - Which medications would mother use for neonatal substance withdrawal
occur?
Substance withdrawal in the newborn occurs when the mother uses drugs that have
addictive properties during pregnancy.
This includes illegal drugs, alcohol, tobacco, and prescription medications. - Fetal alcohol syndrome (FAS)
Results from the chronic or periodic intake of alcohol during pregnancy.
Alcohol is considered teratogenic, so the daily intake of alcohol increases the risk of
FAS.Newborns who have FAS are at risk for specific congenital physical defects and
longterm complications. - Neonatal substance withdrawal: Long term Complications
Ï Feeding problems
Ï CNS dysfunction (cognitive impairment, cerebral palsy)
Ï Attention deficit disorder
Ï Language abnormalities
Ï Microcephaly
Ï Delayed growth and development
Ï Poor maternalnewborn bonding - Neonatal substance withdrawal: Risk Factors
Ï Maternal use of substances prior to knowing she is pregnant
Ï Maternal substance use during pregnancy - Neonatal substance withdrawal: Expected Findings
Monitor the neonate for abstinence syndrome (withdrawal) and increased wakefulness
using the neonatal abstinence scoring system that assesses for and scores the
following.
Ï CNS: Highpitched, shrill cry; incessant crying;irritability; tremors; hyperactivity with an
increased Moro reflex; increased deeptendon reflexes; increased muscle tone;
disturbed sleep pattern; hypertonicity;convulsions
Ï Metabolic, vasomotor, and respiratory findings: Nasal congestion with flaring, frequent
yawning, skin mottling,retractions, apnea, tachypnea greater than 60/min,sweating,
temperature greater than 37.2° C (99° F)
Ï Gastrointestinal: Poor feeding; regurgitation (projectile vomiting); diarrhea; excessive,
uncoordinated, constant sucking
- Opiate Withdrawl: Expected findings
Manifestations of neonatal abstinence syndrome - Heroin Withdrawal: Expected findings
Ï Low birth weight
Ï Small for gestational age (SGA)
Ï Manifestations of neonatal abstinence syndrome
Ï Increased risk of sudden infant death syndrome (SIDS) - Methadone Withdrawal: Expected findings
Manifestations of neonatal abstinence syndrome:
Increased incidence of seizures,sleep pattern disturbances,higher birth weights
(compared to with heroin exposure) - Marijuana Withdrawl: Expected findings
Ï Preterm birth, meconium staining
Ï Longterm effects, such as deficits in attention, cognition,memory, and motor - Amphetamine Withdrawl:Expected findings
Preterm or SGA,drowsiness, jitteriness, sleep pattern disturbances,respiratory distress,
frequent infections,poor weight gain,emotional disturbances,and delayed growth and
development - Alcohol Withdrawal: Expected findings
Jitteriness, irritability,increased tone and reflex responses,and seizures - Fetal Alcohol Syndrome: Expected findings
Ï Facial anomalies: small eyes, flat midface, smooth philtrum, thin upper lip, eyes with a
wide spaced appearance, epicanthal folds, strabismus, ptosis, poor suck,small teeth,
and cleft lip or palate
Ï Deafness
Ï Abnormal palmar creases and irregular hair
Ï Many vital organ anomalies, such as heart defects, including atrial and ventricular
septal defects, tetralogy of Fallot, and patent ductus arteriosus
Ï Developmental delays and neurologic abnormalities
Ï Prenatal and postnatal growth delays
Ï Sleep disturbances