Study suggests better opioid-exposed infant care 2023

Whole-body therapeutic hypothermia, a common treatment for mild or severe NE in younger newborns, was examined. Brain oxygen deficiency causes NE, a congenital defect. Many clinicians utilize therapeutic hypothermia for infants born at 35 weeks or fewer, despite data supporting its use for 36-week-olds.

Therapeutic hypothermia, the only evidence-based treatment for neonates with neonatal encephalopathy (NE) at or after 36 weeks, does not reduce death or moderate/severe impairment in newborns born between 33 and 35 weeks, according to a recent study.

Whole-body therapeutic hypothermia, a common treatment for mild or severe NE in younger newborns, was examined. Brain oxygen deficiency causes NE, a congenital defect. Many clinicians utilize therapeutic hypothermia for infants born at 35 weeks or fewer, despite data supporting its use for 36-week-olds.

The Pediatric Academic Societies (PAS) 2023 Meeting, April 27–May 1 in Washington, DC, will present the research.

The trial included 168 NE-afflicted 33-36-week-olds. Half of these neonates got therapeutic hypothermia, while the other half maintained normal temperature for 72 hours. Trial participants got brain MRIs at seven to 21 days and neuro-developmental testing with hearing and vision assessments at 18-22 months.

Compared to normal-temperature neonates, researchers reported a 77% increase in death. Therapeutic hypothermia did not reduce death or moderate/severe impairment in trial participants. 18-22-month outcomes were examined.

“Despite no evidence supporting its use in younger newborns, clinicians continue to use therapeutic hypothermia in newborns younger than 36 weeks,” stated Roger G. Faix, MD, University of Utah professor of pediatrics/neonatology and presenting author. “These study findings are clear: therapeutic hypothermia is ineffective in more premature newborns.”

Newborns went home a week earlier than those receiving normal care. 20 percent received opioids to alleviate withdrawal symptoms such tremors and hard-to-soothe crying, compared to 52 percent of standard-care newborns. After prenatal exposure to opioids, including methadone, babies can develop withdrawal symptoms. Hospitals employ a scoring system to determine whether newborns need withdrawal medication in newborn critical care units.