Assessment of Drug Dependence in Neonates Due to Intra-Uterine Drug Exposure- Neonatal Abstinence Syndrome

Abstract

A female, during her pregnancy, if consumes drugs exposes her fetus to the drug in its intra-uterine life. Once the drug enters the body, it sends information from VTA to the nucleus accumbens and then to the prefrontal cortex, activating the reward center in the brain. The fetus is exposed to this drug passing through the placenta. The drug binds to the mu receptors and causes hyperpolarisation of receptors. As a result, there is an increase in levels of dopamine. Due to this repetitive cycle, the fetal brain interprets these increased dopamine levels as resting dopamine levels. After delivery, the baby is now no longer under the drug influence. Due to abrupt cessation, the body cannot cope and undergoes withdrawal symptoms; this condition is known as “Neonatal Abstinence Syndrome (NAS).”  The baby shows various symptoms like crankiness, irritation, loud crying, fever, jaundice, tremors, etc. The baby is treated with medicines that the same drug family is exposed to during intrauterine life, such as buprenorphine and methadone. The doses are given to help the infant adjust to the abrupt stoppage of the drug, gradually decreasing the dosage to help wean off the drug. Early and timely treatment with close observation of both the infant and the mother is crucial.