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Author Credentials

OMSIV (Workman)

MD (Bodine)

DO (Tuttle)

Author ORCID Identifier

ABodine, MD 0000-0002-9879-8174

Abstract

Context: The United States opioid epidemic has been an ongoing public health crisis. Nationally, maternal opioid use resulted in 82% increase in Neonatal Abstinence Syndrome (NAS), from 2010 to 2017. The opioid withdrawal process of NAS can lead to somatic dysfunctions. Osteopathic Manipulative Treatment (OMT) may decrease muscular and fascial strain in the body and provide relaxation to the NAS neonate.

Objectives: The objectives of this study were to compare the length of hospital stay (LOS) of NAS neonates who received OMT, and neonates given standard medical care without OMT and to evaluate the change in weight of the two groups.

Methods: This was a retrospective cohort study of NAS neonates who received either OMT added to standard medical care or standard medical care alone at Berkshire Medical Center (BMC) in Pittsfield, Massachusetts from January 1, 2013, to December 31, 2018. IRB exemption was obtained. Information was obtained from the electronic medical records. Inclusion criteria were neonates delivered at BMC and diagnosed with NAS. Exclusion criteria were neonates transferred to a tertiary care facility. Data was separated into two groups, OMT and standard medical care only. Records were reviewed for LOS and change in weight. The de-identified data was analyzed and compared via T-tests.

Results: A total of 175 neonates coded for NAS during the study period, with 2 neonates excluded for transfer, leaving 173 (98.86%) neonates meeting the inclusion criteria. Of the 173 neonates 40 (23.12%) received OMT and 133 (76.88%) received standard medical care only. The LOS for all subjects ranged from 2 to 62 days (M=17.06, SD=10.48). In the OMT group, the LOS ranged from 3 to 45 days (M=17.40, SD=14.8). In the standard medical care-only group the LOS ranged from 2 to 62 days (M=16.61, SD=13.1). There was no significant difference in LOS between the OMT and standard medical care-only groups, t (173) = 0.73, p= 0.649. The change in weight for all subjects ranged from a loss of 15.7 ounces to a gain of 54.1 ounces (M=+7.00, SD=14.12) with an average daily weight gain of 0.4 ounces. In the OMT group the change in weight ranged from a loss of 13.9 ounces to a gain of 51.4 ounces (M=+7.00, SD=11.4) with an average daily weight gain of 0.4 ounces. In the standard medicalcare-only group the change in weight ranged from a loss of 15.7 ounces to a gain of 54.1 ounces (M=+6.40, SD=9.19) with an average daily weight gain of 0.4 ounces. There was no significant difference in weight change between the OMT and standard medical care-only groups, t(170) = 0.03, p= 0.791. Seven providers provided osteopathic consultation and treatment in the OMT group. We reject our hypotheses that there is an association between LOS or weight change in NAS neonates treated with OMT compared to standard medical care only.

Conclusion: OMT has previously been shown to have similar or beneficial outcomes to standard medical care. In this study, a direct relationship between LOS or change in weight between NAS neonates treated with OMT compared to standard medical care alone was not found. The findings showed similar low and high ranges in the OMT group compared to the standard medical care only group, suggesting that OMT is a safe option for NAS neonates.

Creative Commons License

Creative Commons Attribution-NonCommercial 4.0 International License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License

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