ArticlePediatrics2015
Implementation of a Neonatal Abstinence Syndrome Weaning Protocol: A Multicenter Cohort Study.
Article in Pediatrics, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02851303 (Morphine Versus Methadone for Opiate Exposed Infants With Neonatal Abstinence Syndrome), which is not on this map. Cited by 32 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Morphine Versus Methadone for Opiate Exposed Infants With Neonatal Abstinence Syndrome
Who cites it
32 citing papers in PubMed, 2 syntheses or guidelines pooled it, 81 citations in OpenAlex.
- Non-pharmacological care for opioid withdrawal in newborns.The Cochrane database of systematic reviews · 2020Pooled it
- Outcome reporting in neonates experiencing withdrawal following opioid exposure in pregnancy: a systematic review.Trials · 2020Pooled it
- Accelerated Weaning of Opioids to Reduce Pharmacologic Exposure for Neonatal Opioid Withdrawal Syndrome: A Randomized Clinical Trial.The Journal of pediatrics · 2026Trial
- Extended-Release vs Sublingual Buprenorphine in Pregnancy Through 12 Months Post Partum: A Randomized Clinical Trial.JAMA internal medicine · 2026Trial
- Morphine versus methadone for neonatal opioid withdrawal syndrome: a randomized controlled pilot study.BMC pediatrics · 2022Trial
- Article
- Hospital Quality Indicators for Opioid-Exposed Infants: Results From an Expert Consensus Panel.Pediatrics · 2024Article
- Advances in the Care of Infants With Prenatal Opioid Exposure and Neonatal Opioid Withdrawal Syndrome.Pediatrics · 2024Review
- A Systematic Review of Clinical Practice Guidelines for Neonatal Abstinence Syndrome.Children (Basel, Switzerland) · 2023Review
- Implementation of an Inhaled Nitric Oxide Weaning Protocol and Stewardship in a Level 4 NICU to Decrease Inappropriate Use.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2022Article
- A Preliminary Assessment of the Effects of Pharmacist-Driven Methadone Stewardship for the Treatment of Neonatal Abstinence Syndrome at a Tertiary Children's Hospital.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2022Article
- Comparison of Two Morphine Dosing Strategies in the Management of Neonatal Abstinence Syndrome.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2022Article
- Integrated Review of the Assessment of Newborns With Neonatal Abstinence Syndrome.Journal of obstetric, gynecologic, and neonatal nursing : JOGNN · 2021Review
- Clinical pharmacology and dosing regimen optimization of neonatal opioid withdrawal syndrome treatments.Clinical and translational science · 2021Review
- Physiologic Indirect Response Modeling to Describe Buprenorphine Pharmacodynamics in Newborns Treated for Neonatal Opioid Withdrawal Syndrome.Clinical pharmacokinetics · 2021Article
- Medication treatment for opioid use disorder in expectant mothers (MOMs): Design considerations for a pragmatic randomized trial comparing extended-release and daily buprenorphine formulations.Contemporary clinical trials · 2020Article
- Neonatal abstinence syndrome management in California birth hospitals: results of a statewide survey.Journal of perinatology : official journal of the California Perinatal Association · 2020Article
- Neonatal Abstinence Syndrome Incidence and Health Care Costs in the United States, 2016.JAMA pediatrics · 2020Article
- The ACT NOW Clinical Practice Survey: Gaps in the Care of Infants With Neonatal Opioid Withdrawal Syndrome.Hospital pediatrics · 2019Article
- Pharmacologic treatment of infants with neonatal abstinence syndrome in community hospitals compared to academic medical centers.Journal of perinatology : official journal of the California Perinatal Association · 2018Article
Corrections and comments
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Authors and funding
12 authors at 7 institutions in 2 countries.
Funding
Abstract
objectivesTo evaluate the generalizability of stringent protocol-driven weaning in improving total duration of opioid treatment and length of inpatient hospital stay after treatment of neonatal abstinence syndrome (NAS).
methodsWe conducted a retrospective cohort analysis of 981 infants who completed pharmacologic treatment of NAS with methadone or morphine from January 2012 through August 2014. Before July 2013, 3 of 6 neonatology provider groups (representing Ohio's 6 children's hospitals) directed NAS nursery care by using group-specific treatment protocols containing explicit weaning guidelines. In July 2013, a standardized weaning protocol was adopted by all 6 groups. Statistical analysis was performed to identify effects of adoption of the multicenter weaning protocol on total duration of opioid treatment and length of hospital stay at the protocol-adopting sites and at the sites with preexisting protocol-driven weaning.
resultsAfter adoption of the multicenter protocol, infants treated by the 3 groups previously without stringent weaning guidelines experienced shorter duration of opioid treatment (23.0 vs 34.0 days, P < .001) and length of inpatient hospital stay (23.7 vs 31.6 days, P < .001). Protocol-adopting sites also experienced a lower rate of adjunctive drug therapy (5% vs 21%, P = .004). Outcomes were sustained by the 3 groups who initially had specific weaning guidelines after multicenter adoption (duration of treatment = 17.0 days and length of hospital stay = 23.3 days).
conclusionsAdoption of a stringent weaning protocol resulted in improved NAS outcomes, demonstrating generalizability of the protocol-driven weaning approach. Opportunity remains for additional protocol refinement.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.