Social Ecological Examination of Factors That Influence the Treatment of Newborns With Neonatal Abstinence Syndrome

J Obstet Gynecol Neonatal Nurs. 2018 Jul;47(4):509-519. doi: 10.1016/j.jogn.2018.04.135.

Abstract

Health care systems are challenged with issues of overdiagnosis and overtreatment. Neonatal abstinence syndrome (NAS) may be overdiagnosed with standardized assessment protocols and may be overtreated with current NICU-based models of care. Clinical approaches to caring for neonates with NAS and their families have not significantly changed for 40 years, and there is growing interest in revisiting long-standing routine practices. I used Bronfenbrenner's social ecological systems framework to organize an exploration of factors that contribute to overdiagnosis and overtreatment in the care of neonates with NAS.

Keywords: infant; neonatal abstinence syndrome; neonatal opioid withdrawal; neonate; overdiagnosis; overtreatment.

MeSH terms

  • Analgesics, Opioid / administration & dosage
  • Disease Management
  • Humans
  • Infant, Newborn
  • Medical Overuse / statistics & numerical data*
  • Medicalization / statistics & numerical data*
  • Neonatal Abstinence Syndrome / diagnosis*
  • Neonatal Abstinence Syndrome / drug therapy
  • Opiate Substitution Treatment / methods

Substances

  • Analgesics, Opioid