Eat, sleep and console model of care for managing infants with neonatal abstinence syndrome: a meta-analysis of observational studies

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Argitaratua izan da:Archives of Disease in Childhood (May 2025), p. archdischild-2025-328549
Egile nagusia: Wei, Zoe
Beste egile batzuk: Abdel-Latif, Mohamed E, Cope, James, Ju-Lee, Oei
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BMJ Publishing Group LTD
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Sarrera elektronikoa:Citation/Abstract
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022 |a 0003-9888 
022 |a 1468-2044 
024 7 |a 10.1136/archdischild-2025-328549  |2 doi 
035 |a 3205936034 
045 2 |b d20250501  |b d20250531 
084 |a 270345  |2 nlm 
100 1 |a Wei, Zoe  |u Faculty of Children’s Health, University of New South Wales, Kensington Campus, Sydney, New South Wales, Australia; Bankstown-Lidcombe Hospital, Bankstown, New South Wales, Australia 
245 1 |a Eat, sleep and console model of care for managing infants with neonatal abstinence syndrome: a meta-analysis of observational studies 
260 |b BMJ Publishing Group LTD  |c May 2025 
513 |a Evidence Based Healthcare Journal Article 
520 3 |a ImportanceVigilant clinical assessment is the key to preventing complications, including death, in infants at risk of neonatal withdrawal syndrome. The eat, sleep and console (ESC) is proposed as an alternative to usual care with Finnegan’s Neonatal Abstinence Scoring System (FNASS), but whether ESC improves infant outcomes is uncertain.ObjectiveTo conduct a meta-analysis and systematic review of outcomes of studies comparing ESC to FNASS.Data sourcesPubMed, Embase, CINAHL and Cochrane were searched. There was no date restriction.Study selectionPublished data from observational studies published in English were included. Randomised controlled trials, reviews and abstracts were excluded. Data was required to be converted to mean and SD to be included.Data extraction and synthesisPreferred Reporting Items for Systematic reviews and Meta-Analyses guidelines were used, and data were independently extracted by multiple observers. Data was pooled using a random-effects model.Main outcome and measuresLength of stay (LOS) in days, number of days medicated and proportion of infants medicated were the primary outcomes assessed. It was hypothesised prior to data collection that ESC would be associated with shorter LOS and a lower proportion of infants medicated, given key differences in infant assessment compared with the FNASS.Results12 studies, all from the USA, were published between 2018 and 2024. 10 quality improvement studies and two cohort studies compared ESC (n=1877) with historical controls using FNASS (n=2199). ESC decreased hospitalisation days (MD −4.11 days, 95% CI −6.04 to −2.19 days; p<0.0001; I2=95%; 10 studies; 3703 participants) and the proportion treated with withdrawal medications (OR 0.36, 95% CI 0.22 to 0.60; I2=89%; RD −0.22; 95% CI −0.34 to −0.10; p<0.0001; I2=93%; 12 studies; 4076 participants). One study assessed physical health up to 1 week after discharge (n=1), three assessed weight loss (n=3) and one assessed cost (n=1).Conclusions and relevanceThe majority of evidence for a reduction in hospitalisation and need for withdrawal medication with ESC compared with FNASS is derived from quality improvement and cohort studies with almost no health information beyond 1 week after discharge. High-quality trials incorporating physiological measurements of infant stress and longer-term outcomes are needed.Review prospective registration<ext-link ext-link-type="uri" xlink:href="http://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024532169">CRD42024532169</ext-link>. 
651 4 |a United States--US 
653 |a Clinical trials 
653 |a Drug withdrawal 
653 |a Software 
653 |a Neonates 
653 |a Sleep 
653 |a Collaboration 
653 |a Observational studies 
653 |a Infants 
653 |a Hospitalization 
653 |a Narcotics 
653 |a Drug therapy 
653 |a Data collection 
653 |a Neonatal abstinence syndrome 
653 |a Quality control 
653 |a Cohort analysis 
653 |a Quality improvement 
653 |a Meta-analysis 
653 |a Body weight loss 
653 |a Systematic review 
653 |a Babies 
653 |a Length of stay 
653 |a Stress 
653 |a Social 
653 |a Control Groups 
653 |a Sample Size 
653 |a Meta Analysis 
653 |a Young Children 
653 |a Outcome Measures 
653 |a Body Weight 
653 |a Search Strategies 
653 |a Information Seeking 
653 |a Computer Software Reviews 
653 |a Research Tools 
653 |a Pregnancy 
653 |a Database Management Systems 
653 |a Flow Charts 
700 1 |a Abdel-Latif, Mohamed E  |u Department of Neonatology, Canberra Hospital, Canberra, Australian Capital Territory, Australia; Department of Public Health, La Trobe University College of Science Health and Engineering, Bundoora, Victoria, Australia 
700 1 |a Cope, James  |u University of New South Wales, Sydney, New South Wales, Australia 
700 1 |a Ju-Lee, Oei  |u School of Paediatrics, Faculty of Medicine and Health, UNSW Sydney, Sydney, New South Wales, Australia; Department of Newborn Care, Royal Hospital for Women, Sydney, New South Wales, Australia 
773 0 |t Archives of Disease in Childhood  |g (May 2025), p. archdischild-2025-328549 
786 0 |d ProQuest  |t Science Database 
856 4 1 |3 Citation/Abstract  |u https://www.proquest.com/docview/3205936034/abstract/embedded/75I98GEZK8WCJMPQ?source=fedsrch 
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856 4 0 |3 Full Text - PDF  |u https://www.proquest.com/docview/3205936034/fulltextPDF/embedded/75I98GEZK8WCJMPQ?source=fedsrch