{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T01:26:02Z","timestamp":1794273962722,"version":"4.9.0"},"reference-count":31,"publisher":"American Academy of Pediatrics (AAP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,1]]},"abstract":"\n BACKGROUND AND OBJECTIVES<\/jats:title>\n Identifying neonates at risk for neonatal opioid withdrawal syndrome (NOWS) is important to ensure adequate monitoring and treatment. We sought to evaluate 3 screening modalities\u2014maternal history and physical (H&P), maternal urine drug screening (MUDS), and neonatal urine drug screening (NUDS)\u2014in the identification of neonates at risk for NOWS.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n Retrospective chart review was conducted for neonates with documented neonatal Finnegan scores at the University of Maryland Medical Center in Baltimore, Maryland, from January 1, 2017, through January 1, 2022. Maternal H&P was reviewed in addition to MUDS and NUDS. The institution\u2019s criterion for pharmacologic intervention is 2 or more consecutive Finnegan scores of 9 or greater. Treatment receipt was defined as documentation of morphine administration for treatment of withdrawal.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n Of the 460 neonates included, most (452 (98.3%) were identified by maternal screening, which included a documented maternal history of opioid use or a positive MUDS result. No neonates received monitoring for NOWS based solely on NUDS. Maternal history of opioid use also had the highest sensitivity for identifying neonates who received treatment for NOWS (96.1%).<\/jats:p>\n <\/jats:sec>\n \n CONCLUSION<\/jats:title>\n Maternal screening modalities including history and urine toxicology identify almost all neonates who require monitoring for NOWS. NUDS did not identify additional at-risk neonates. Prospective studies are warranted to assess a balanced approach to NUDS that prioritizes newborn safety while reducing maternal stigmatization and minimizing separation.<\/jats:p>\n <\/jats:sec>","DOI":"10.1542\/peds.2024-068612","type":"journal-article","created":{"date-parts":[[2025,8,12]],"date-time":"2025-08-12T00:03:06Z","timestamp":1754956986000},"source":"Crossref","is-referenced-by-count":4,"title":["Maternal and Infant Opioid Screening for Neonates at Risk"],"prefix":"10.1542","volume":"156","author":[{"given":"Kristina G.","family":"Witcher","sequence":"first","affiliation":[{"name":"Department of Obstetrics, Gynecology & Reproductive Sciences, University of Maryland School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Huddleson","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology & Reproductive Sciences, University of Maryland School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayda","family":"Soltanian","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology & Reproductive Sciences, University of Maryland School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dina","family":"El-Metwally","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology & Reproductive Sciences, University of Maryland School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrina","family":"Mark","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology & Reproductive Sciences, University of Maryland School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2025,8,12]]},"reference":[{"key":"2026050605365985000_r1","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.earlhumdev.2018.10.010","article-title":"Association between prenatal opioid exposure, neonatal opioid withdrawal syndrome, and neurodevelopmental and behavioral outcomes at 5\u20138\u00a0months of age","volume":"128","author":"Bakhireva","year":"2019","journal-title":"Early Hum Dev."},{"issue":"2","key":"2026050605365985000_r2","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1001\/jama.2020.24991","article-title":"Neonatal abstinence syndrome and maternal opioid-related diagnoses in the US, 2010\u20132017","volume":"325","author":"Hirai","year":"2021","journal-title":"JAMA."},{"key":"2026050605365985000_r3","doi-asserted-by":"crossref","first-page":"106978","DOI":"10.1016\/j.ntt.2021.106978","article-title":"Clinical care of neonates undergoing opioid withdrawal in the immediate postpartum period","volume":"86","author":"Oji-Mmuo","year":"2021","journal-title":"Neurotoxicol Teratol."},{"issue":"25","key":"2026050605365985000_r4","doi-asserted-by":"crossref","first-page":"2326","DOI":"10.1056\/NEJMoa2214470","article-title":"Eat, Sleep, Console approach or usual care for neonatal opioid withdrawal","volume":"388","author":"Young","year":"2023","journal-title":"N Engl J Med."},{"issue":"6","key":"2026050605365985000_r5","doi-asserted-by":"crossref","first-page":"e20163360","DOI":"10.1542\/peds.2016-3360","article-title":"An initiative to improve the quality of care of infants with neonatal abstinence syndrome","volume":"139","author":"Grossman","year":"2017","journal-title":"Pediatrics."},{"key":"2026050605365985000_r6","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.drugalcdep.2017.11.030","article-title":"Prenatal exposure to methadone or buprenorphine: early childhood developmental outcomes","volume":"185","author":"Kaltenbach","year":"2018","journal-title":"Drug Alcohol Depend."},{"issue":"5","key":"2026050605365985000_r7","doi-asserted-by":"crossref","first-page":"e2020029074","DOI":"10.1542\/peds.2020-029074","article-title":"Neonatal opioid withdrawal syndrome","volume":"146","author":"Patrick","year":"2020","journal-title":"Pediatrics."},{"issue":"1\u20132","key":"2026050605365985000_r8","first-page":"141","article-title":"Neonatal abstinence syndrome: assessment and management","volume":"2","author":"Finnegan","year":"1975","journal-title":"Addict Dis."},{"issue":"1","key":"2026050605365985000_r9","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1542\/hpeds.2017-0128","article-title":"A novel approach to assessing infants with neonatal abstinence syndrome","volume":"8","author":"Grossman","year":"2018","journal-title":"Hosp Pediatr."},{"issue":"6","key":"2026050605365985000_r10","doi-asserted-by":"crossref","first-page":"1364","DOI":"10.1038\/s41372-020-00893-8","article-title":"Definitions of neonatal abstinence syndrome in clinical studies of mothers and infants: an expert literature review","volume":"41","author":"Jilani","year":"2021","journal-title":"J Perinatol."},{"issue":"6","key":"2026050605365985000_r11","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1177\/000992287501400613","article-title":"A pragmatic evaluation of its efficacy","volume":"14","author":"Lipsitz","year":"1975","journal-title":"Clin Pediatr (Phila)."},{"issue":"2","key":"2026050605365985000_r12","doi-asserted-by":"crossref","first-page":"e81","DOI":"10.1097\/AOG.0000000000002235","article-title":"711: Opioid use and opioid use disorder in pregnancy","volume":"130","author":"Committee Opinion No","year":"2017","journal-title":"Obstet Gynecol."},{"issue":"2","key":"2026050605365985000_r13","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1097\/AOG.0000000000004808","article-title":"Challenges in perinatal drug testing","volume":"140","author":"Kurtz","year":"2022","journal-title":"Obstet Gynecol."},{"issue":"1","key":"2026050605365985000_r14","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.jogn.2022.10.002","article-title":"Drug testing practices and policies of labor and delivery units across the southeastern United States","volume":"52","author":"Byrd","year":"2023","journal-title":"J Obstet Gynecol Neonatal Nurs."},{"issue":"6","key":"2026050605365985000_r15","doi-asserted-by":"crossref","first-page":"100733","DOI":"10.1016\/j.ajogmf.2022.100733","article-title":"Urine drug screening on labor and delivery","volume":"4","author":"Chin","year":"2022","journal-title":"Am J Obstet Gynecol MFM."},{"issue":"7","key":"2026050605365985000_r16","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1080\/00981389.2014.916375","article-title":"Screening, testing, and reporting for drug and alcohol use on labor and delivery: a survey of Maryland birthing hospitals","volume":"53","author":"Miller","year":"2014","journal-title":"Soc Work Health Care."},{"issue":"7","key":"2026050605365985000_r17","doi-asserted-by":"crossref","first-page":"100963","DOI":"10.1016\/j.ajogmf.2023.100963","article-title":"Assessing the clinical utility of toxicology testing in the peripartum period","volume":"5","author":"Siegel","year":"2023","journal-title":"Am J Obstet Gynecol MFM."},{"issue":"4","key":"2026050605365985000_r18","doi-asserted-by":"crossref","first-page":"445","DOI":"10.3233\/NPM-16153","article-title":"Newborn drug testing practices in Iowa birthing hospitals","volume":"10","author":"Wood","year":"2017","journal-title":"J Neonatal Perinatal Med."},{"issue":"4","key":"2026050605365985000_r19","first-page":"353","article-title":"Neonatal abstinence syndrome, pharmacotherapy and developmental outcome","volume":"8","author":"Kaltenbach","year":"1986","journal-title":"Neurobehav Toxicol Teratol."},{"issue":"1","key":"2026050605365985000_r20","first-page":"34","article-title":"What makes a screening exam \u201cgood\u201d?","volume":"8","author":"Herman","year":"2006","journal-title":"Virtual Mentor."},{"issue":"13","key":"2026050605365985000_r21","doi-asserted-by":"crossref","first-page":"811","DOI":"10.3109\/08958378.2014.955932","article-title":"Screening tests: a review with examples","volume":"26","author":"Maxim","year":"2014","journal-title":"Inhal Toxicol."},{"key":"2026050605365985000_r22","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.jpeds.2021.12.021","article-title":"Standardizing the clinical definition of opioid withdrawal in the neonate","volume":"243","author":"Jilani","year":"2022","journal-title":"J Pediatr."},{"issue":"3","key":"2026050605365985000_r23","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/j.jcm.2011.08.004","article-title":"The 4 basic ethical principles that apply to forensic activities are respect for autonomy, beneficence, nonmaleficence, and justice","volume":"10","author":"Jahn","year":"2011","journal-title":"J Chiropr Med."},{"issue":"1","key":"2026050605365985000_r24","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1007\/s10995-015-1799-6","article-title":"Validity of self-reported drug use information among pregnant women","volume":"20","author":"Garg","year":"2016","journal-title":"Matern Child Health J."},{"issue":"2","key":"2026050605365985000_r25","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1080\/10550887.2020.1831137","article-title":"Drug testing in biological samples vs. maternal surveys for the detection of substance use during whole pregnancy","volume":"39","author":"Gonz\u00e1lez-Colmenero","year":"2021","journal-title":"J Addict Dis."},{"issue":"4","key":"2026050605365985000_r26","doi-asserted-by":"crossref","first-page":"582","DOI":"10.15288\/jsad.2022.83.582","article-title":"On the desirability of social desirability measures in substance use research","volume":"83","author":"Verg\u00e9s","year":"2022","journal-title":"J Stud Alcohol Drugs."},{"key":"2026050605365985000_r27","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/s40352-015-0015-5","article-title":"Pregnant women and substance use: fear, stigma and barriers to care","volume":"3","author":"Stone","year":"2015","journal-title":"Health Justice."},{"issue":"11","key":"2026050605365985000_r28","doi-asserted-by":"crossref","first-page":"1585","DOI":"10.3109\/10826089909039416","article-title":"Agreement between urinalysis and self-reported drug use","volume":"34","author":"Hamid","year":"1999","journal-title":"Subst Use Misuse."},{"issue":"6","key":"2026050605365985000_r29","doi-asserted-by":"crossref","first-page":"667","DOI":"10.2105\/AJPH.76.6.667","article-title":"Maternal marijuana use and neonatal outcome: uncertainty posed by self-reports","volume":"76","author":"Hingson","year":"1986","journal-title":"Am J Public Health."},{"issue":"1","key":"2026050605365985000_r30","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1097\/AOG.0000000000001781","article-title":"Neonatal abstinence syndrome and ethical approaches to the identification of pregnant women who use drugs","volume":"129","author":"Terplan","year":"2017","journal-title":"Obstet Gynecol."},{"key":"2026050605365985000_r31","doi-asserted-by":"crossref","first-page":"961","DOI":"10.3389\/fphar.2018.00961","article-title":"Screening pregnant women and their neonates for illicit drug use: consideration of the integrated technical, medical, ethical, legal, and social issues","volume":"9","author":"Price","year":"2018","journal-title":"Front Pharmacol."}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2024-068612\/1842862\/pediatrics.2024068612.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2024-068612\/1842862\/pediatrics.2024068612.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T09:37:11Z","timestamp":1778060231000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/156\/3\/e2024068612\/203123\/Maternal-and-Infant-Opioid-Screening-for-Neonates"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,12]]},"references-count":31,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,8,12]]},"published-print":{"date-parts":[[2025,9,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2024-068612","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,12]]},"article-number":"e2024068612"}}