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Table 1 Studies of tools to assess neonatal abstinence syndrome

From: Review of the assessment and management of neonatal abstinence syndrome

Reference Index vs. reference group(s) Scale Primary results
Finnegan, 1975[29] 37 infants assessed with NASS vs. 37 infants born prior to development of NASS Neonatal Narcotic Abstinence Scoring System Mean inter-rater reliability coefficient: 0.82 (0.75–0.96)
Exposure methadone and heroin 20 items, weighted on pathologic severity Management of NAS without drug Rx: 30% vs. 46%
   LOS: 6 days vs. 8 days
   Total Rx days decreased by 25%
Lipsitz, 1975[31] 41 infants evaluated by 2 pediatric residents, placed in 5 groups, one group which was opioid exposed Narcotic Withdrawal Score Only the infants exposed to opioids had scores ≥ 5; concluded that a score > 4 suggests a clinical threshold for Rx
Exposure methadone and heroin 11 items, scored 0–3 based on severity  
Green, 1981[32] Infants exposed to methadone or heroin(n = 50) Neonatal Narcotic Withdrawal Index Inter-rater reliability coefficient: 0.771*
Control infants (n = 40) 7 items, scored 0–2 based on severity Mean NAS score on day 2 of life: 1.57 vs. 3.08*
  7th item is “other” and includes 12 other symptoms  
Zahorodny, 1998[33] Group A: opioid-exposed infants with NAS (n = 30) Neonatal Withdrawal Inventory Group A: inter-rater reliability coefficient: 0.89–0.98
Group B: opioid infants with NAS (n = 12) and nonopioid-exposed controls (n = 13) 8 items given predetermined weights Group B: sensitivity and specificity for NAS diagnosis: 100%, 100%
Group C: opioid-exposed infants with NAS (n = 25)   Group C: sensitivity and specificity for Rx threshold vs. the NASS: 100%, 100%
Jones, 2010[3] 131 opioid-exposed infants, scored using the same scale MOTHER NAS scale (modified Finnegan) Intraclass correlation coefficient > 0.94
Exposure methadone or buprenorphine   
  1. Abbreviations: NAS Neonatal Abstinence Syndrome, NASS Neonatal Abstinence Scoring System, Rx Treatment, LOS Length of Hospital Stay.
  2. *indicated p < 0.05.