Neonatal abstinence syndrome (NAS) is a drug withdrawal syndrome experienced by some opioid-exposed infants which has increased significantly over the last two decades. Many infants exposed to opioids do not develop the syndrome.
A team of researchers from the Vanderbilt Center for Child Health Policy developed and internally validated a predictive model that estimates NAS risk among infants at high-risk for developing the syndrome (exposed to opioids or hepatitis C virus).1 The interactive tool below allows for the input of maternal demographics as well as information about antenatal exposure during the last 30 days of pregnancy and yields a predicted risk of NAS (in red) specifically for that infant.
Drag and drop along the scales and make selections to see the % chance that an infant develops NAS. Note the gray ribbon which represents the 95% confidence interval for each prediction, as well as the intersection of the red lines which marks the current input values. Try out the example described below to further your understanding.
There are limitations in the use of this tool that should be considered:
- Although we performed a robust internal validation of our model, the model should be validated in an external population and recalibrated before it is considered for use in clinical settings.
- As with all clinical prediction tools, this tool may not perform as well among different populations when validated.
- These data were obtained from Medicaid-enrolled maternal-infant dyads in Tennessee and may not be generalizable outside of this program.
- The model is not well-calibrated for high-risk infants, it may be most useful for use among low-risk infants.
- This study focuses on infants exposed to licit opioids and may not be generalizable to infants exposed to illicit opioids.
- We could not assess differences in NAS risk between methadone and buprenorphine as most of the population in the study used buprenorphine for OUD and not methadone.
1Patrick SW, Slaughter JC, Harrell Jr FE, Martin PR, Hartmann K, Dudley J, Stratton S, Cooper WO, Development and Validation of a Model to Predict Neonatal Abstinence Syndrome, The Journal of Pediatrics (2020), doi: https://doi.org/10.1016/j.jpeds.2020.10.030.