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Sommaire

Neonatal Abstinence Syndrome

Syndrome de sevrage néonatal : évaluation de l'acupuncture

1. Systematic Reviews and Meta-Analysis

1.1. Urlesberger 2025

Urlesberger B, Cabano R, Soll G, Pahl A, Oei JL, Schmölzer GM, Raith W, Bruschettini M. Acupuncture for neonatal abstinence syndrome in newborn infants. Cochrane Database Syst Rev. 2025 Feb 21;2:CD014160. https://doi.org/10.1002/14651858.CD014160.pub2

BackgroundNeonatal abstinence syndrome (NAS) is a withdrawal condition occurring after in-utero exposure to opioids, characterized by tremors, irritability, and sleep disturbances requiring prolonged hospitalization. Standard treatment combines supportive care and, in severe cases, pharmacologic management. Acupuncture has been proposed as an adjunctive therapy, delivered via invasive or non-invasive techniques such as acupressure and laser stimulation.
ObjectivesTo assess whether acupuncture (needle, laser, or acupressure) reduces the duration of pharmacological treatment, length of hospital stay, and adverse events in newborn infants with NAS.
MethodsCochrane-standard searches were conducted in CENTRAL, PubMed, Embase, and trial registries through August 25, 2023. Eligible studies were randomized or quasi-randomized controlled trials including full-term or late preterm infants diagnosed with NAS within 72 hours of birth. Data extraction and bias assessment followed Cochrane methodology, and evidence certainty was appraised with GRADE.
ResultsTwo single-center RCTs (n = 104 infants) compared non-invasive acupuncture + standard care versus standard care alone. One Austrian RCT (n = 28) used daily laser acupuncture at ear and body points; one U.S. RCT (n = 76) applied auricular acupressure. Median duration of pharmacological therapy was shorter with acupuncture (28 vs 39 days) in one study, but similar in the other (mean difference –0.60 days, 95 % CI –7.45 to 6.25). No adverse effects were reported (RD 0.00, 95 % CI –0.05 to 0.05). Hospital stay tended to be shorter with acupuncture (median 35 vs 50 days), though mean differences were nonsignificant. NAS scores were comparable between groups. Certainty of evidence was rated very low for all outcomes.
ConclusionCurrent evidence is insufficient to determine the benefits or harms of acupuncture for neonatal abstinence syndrome. Non-invasive acupuncture appeared safe but did not demonstrate consistent efficacy. Large, high-quality RCTs comparing acupuncture modalities and standard treatments are required before clinical recommendations can be made.

1.2. Jackson 2019

Jackson HJ, Lopez C, Miller S , Engelhardt B. A Scoping Review of Acupuncture as a Potential Intervention for Neonatal Abstinence Syndrome. Medical Acupuncture. 2019;31(2):69-84. [197692].

ObjectiveNeonatal abstinence syndrome (NAS) has risen drastically over the past decade. Infants with NAS experience extreme discomfort and developmental delays when going into withdrawal. Management includes multiple supportive and nonpharmacologic therapies as first-line treatments in an effort to reduce or prevent the need for medication management. Acupuncture has demonstrated efficacy in adults experiencing withdrawal from addictions, as well as for treating many other conditions in pediatric patients who have similar symptoms to withdrawal. The purpose of this review is to evaluate the safety and efficacy of acupuncture for neonates in withdrawal.
Materials and methodsThis review was guided by the Arksey and O'Malley methodological framework, and analysis was performed based on a social ecological model. The PRISMA [Preferred Reporting Items for Systematic Reviews and Meta-Analyses] statement was used to organize selected publications, and a flow chart was created to display the search process. PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature, and the Cochrane Databases were searched for relevant publications.
ResultsAcupuncture appears to be safe and effective for reducing withdrawal symptoms in infants, and, thus, should be considered as an additional nonpharmacologic treatment option for NAS.

Jackson HJ, López C, Miller S, Englehardt B. Neonatal Abstinence Syndrome: An Integrative Review of Neonatal Acupuncture to Inform a Protocol for Adjunctive Treatment. Adv Neonatal Care. 2019;19(3):165-178. [198062].

Backgroundhe current opioid epidemic in the United States has given rise to a growing incidence of neonatal abstinence syndrome (NAS). Treatments for this condition optimize nonpharmacologic therapies in an effort to improve withdrawal symptoms and reduce or eliminate the need for opioid medications, thereby reducing hospital length of stay and improving healthy neonatal outcomes. PURPOSE: The purpose of this review was to evaluate the current evidence for neonatal acupuncture treatments and identify essential characteristics that must be included in a treatment protocol for NAS.
MethodsMETHODS/SEARCH STRATEGY: An integrative review was conducted under the guidance of the Whittemore and Knafl methodology and near-term infant conceptual framework. An evaluation of the quality and levels of evidence was also included.
Findings/ResultsA total of 10 studies were identified in this review. Four of these studies were randomized controlled trials, and utilized acupuncture in the neonatal population to evaluate impact on pain, NAS, and weight gain.
Implications for practiceThis review provided the essential elements for the development of a complementary acupuncture treatment protocol for the management of NAS.
Implications for researchFuture research should include the identified essential characteristics in high-quality, blinded, randomized controlled trials to assess the treatment effect of acupuncture on neonates experiencing withdrawal symptoms.