Heightened sympathetic arousal is demonstrated by skin conductance responsivity to auditory stimuli in a small cohort of neonates with opiate withdrawal

Abstract

To determine the effects of auditory stimulus on skin conductance (SC) in infants with severe neonatal abstinence syndrome (NAS) that required morphine treatment (MT) compared with NAS infants that did not require morphine treatment (non-MT). We prospectively enrolled opiate-exposed term infants without polysubstance exposure. Skin conductance responses to an auditory stimulus (ringing a bell for 3s) near the time of discharge were obtained. Skin conductance was measured before, during, and after the stimulus. Non-parametric tests were used to determine between group and within phase differences. Infants were off MT at the time of SC measurement in response to an auditory stimulus. In a 2-group comparison of MT vs. non-MT infants, there was significantly higher SC responsivity to an auditory stimulus (p <0.05) in the MT group as compared with the non-MT group near discharge. The mean +SE peak morphine dose was 0.85+0.20mg/kg/day in the MT group. The mean Length of Stay (LOS) was 32 vs. 7 (p <0.05) days respectively, for the MT vs. the non-MT group. Our preliminary data suggest that in infants with severe NAS symptoms, higher sympathetic arousal in response to an auditory stimulus persists at discharge, underscoring the need for ongoing evaluation and specialized care at home.

Keywords: Assessment at discharge; Neonatal abstinence syndrome; Objective assessment; Skin conductance; Sympathetic arousal.

Fig. 1.

Skin conductance in response μS (Mean +/− SE) in response to auditory stimulus near hospital discharge. N = 12. MT = morphine treatment; EDR = electrodermal response; AS = auditory stimulus; μS = μSiemens. *p < 0.05 (Mann Whitney-U test).

Fig. 2.

Correlation between skin conductance mean of peaks (μS) from the post-auditory stimulus phase and length of stay (treated group vs non-treated group, representing those that required morphine treatment vs those that did not require treatment). The Spearman’s (r^s) correlation coefficient 0.77 (p = 0.003).