ArticlePediatrics2025
Adapting a Risk Prediction Tool for Neonatal Opioid Withdrawal Syndrome.
Article in Pediatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Patient-reported outcomes for monitoring substance use treatment: A systematic review of single-item measures.Addiction (Abingdon, England) · 2026Pooled it
- Association between NNNS-II profiles and pharmacological treatment in infants with prenatal opioid exposure.Journal of perinatology : official journal of the California Perinatal Association · 2026Article
- Association between NNNS-II Profiles and Pharmacological Treatment in Infants with Prenatal Opioid Exposure.Research square · 2025Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
backgroundThe American Academy of Pediatrics recommends up to 7 days of observation for neonatal opioid withdrawal syndrome (NOWS) in infants with chronic opioid exposure. However, many of these infants will not develop NOWS, and infants with seemingly less exposure to opioids may develop severe NOWS that requires in-hospital pharmacotherapy. We adapted and validated a prediction model to help clinicians identify infants at birth who will develop severe NOWS.
methodsThis prognostic study included 33 991 births. Severe NOWS was defined as administration of oral morphine. We applied logistic regression with a least absolute shrinkage selection operator approach to develop a severe NOWS prediction model using 37 predictors. To contrast the model with guideline screening criteria, we conducted a decision curve analysis with chronic opioid exposure defined as the mother receiving a diagnosis for opioid use disorder (OUD) or a prescription for long-acting opioids before delivery.
resultsA total of 108 infants were treated with oral morphine for NOWS, and 1243 infants had chronic opioid exposure. The model was highly discriminative, with an area under the receiver operating curve of 0.959 (95% CI, 0.940-0.976). The strongest predictor was mothers' diagnoses of OUD (adjusted odds ratio, 47.0; 95% CI, 26.7-82.7). The decision curve analysis shows a higher benefit with the model across all levels of risk, compared with using the guideline criteria.
conclusionRisk prediction for severe NOWS at birth may better support clinicians in tailoring nonpharmacologic measures and deciding whether to extend birth hospitalization than screening for chronic opioid exposure alone.
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