Effects of Familial Contact on Length of Stay and Finnegan Scoring in Infants Diagnosed with NAS (Neonatal Abstinence Syndrome)

Background & Purpose: Rates of Neonatal Abstinence Syndrome (NAS) have increased due to rising rates of opioid use in the United States, making NAS a leading cause of medical and developmental problems in newborns. NAS presents as a unique social problem as well as a costly issue for hospitals. Previous studies have demonstrated that infants exposed to opiates in utero have prolonged NICU stays lasting around 16 days while suffering withdrawal symptoms which are measured using Finnegan scores. Regional NICUs generally care for these infants, and parents often lack resources to visit frequently. Although evidence suggests that infants who have frequent contact with family recover more quickly, little research exists on effects of length of hospitalization, frequency of family visits, and Finnegan scoring. The current study examines the impact of family visits on the length of NICU stay and Finnegan scores for infants diagnosed with NAS. We hypothesize that lack of family contact will be correlated to higher Finnegan scores and longer lengths of stay for the infants.

Methods: We collected electronic data from institutional archives from 2015 from a regional children’s hospital in Appalachia. Participants include all infants diagnosed with NAS born in 2015 who were admitted to the NICU at East Tennessee Children’s Hospital with a diagnosis of NAS. We obtained family visits from family visit logs, Finnegan scoring from nursing notes, and length of stay from discharge summaries.

Results: Zero-order correlations revealed a strong positive correlation between Finnegan scores and the length of NICU stays, r(74) = .62, p < .001, as well as between NICU length of stays and the length of time without family contact, r(100) = .33, p = .001. To test the hypothesis that length of time without family contact would moderate the relationship between severity of NAS symptoms, as measured by Finnegan scores, and the length of infant NICU stays, moderation analysis was conducted with Hayes PROCESS macro.  The overall model was significant, R² = .47, F(3, 70) = 20.85, p < .001.  While the R² change was small (ΔR² = .04), both Finnegan scores (β = .58, p < .001) and the length of time without family contact (β = .19, p < .05) remained significant in the final model.  

Conclusion: Study findings highlight the significant role that families play in both relieving NAS infant distress and in reducing the length of costly NICU stays. These results demonstrate the importance of consistent familial contact for NAS infants. Social work practitioners in hospital settings educate families regarding the effects of disruptions in family contact on infant distress and well-being. Social workers can also challenge stigma regarding opioid misuse that may contribute to reduced frequency of contact and provide case management to support consistent family visits to infants in NICU care.