Cochrane · systematic review · CD002059
Opioid treatment for opioid withdrawal in newborn infants
Zankl, A, Martin, J, Davey, JG, et al. · Cochrane Database of Systematic Reviews · 2021 · Cochrane Library
NeonatalAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
56
current version
GRADE rated
30
No studies
26
Included studies
NR
No studies 26 · 46.4%Ungraded 0 · 0%Very low 10 · 17.9%Low 16 · 28.6%Moderate 4 · 7.1%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Opioid versus placebo or no treatment / usual care for opioid withdrawal in newborn infants
Population: newborn infants with opioid withdrawal
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Treatment failure To discharge Opioid vs placebo or no treatment / usual care | RR 1.29 [0.41, 4.07] | 1 study · 80 participants | Very low Downgraded: risk of bias, imprecision |
Seizures To discharge Opioid vs placebo or no treatment / usual care | no estimate extracted | 1 study · 80 participants | Very low Downgraded: risk of bias, imprecision |
Neonatal or infant mortality Opioid vs placebo or no treatment / usual care | no estimate extracted | NR | No studies |
Neurodevelopmental disability Opioid vs placebo or no treatment / usual care | no estimate extracted | NR | No studies |
Days hospitalisation Opioid vs placebo or no treatment / usual care | no estimate extracted | 1 study · 80 participants | Very low Downgraded: risk of bias, imprecision |
Days treatment Opioid vs placebo or no treatment / usual care | no estimate extracted | 1 study · 80 participants | Very low Downgraded: risk of bias, imprecision |
Adverse events (treatment‐related) To discharge Opioid vs placebo or no treatment / usual care | no estimate extracted | NR | No studies |
Morphine versus methadone for opioid withdrawal in newborn infants
Population: newborn infants with opioid withdrawal
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Treatment failure To discharge Morphine vs methadone | RR 1.59 [0.95, 2.67] | 2 studies · 147 participants | Low Downgraded: imprecision |
Seizures Morphine vs methadone | no estimate extracted | NR | No studies |
Neonatal or infant mortality Morphine vs methadone | no estimate extracted | NR | No studies |
Neurodevelopmental disability Morphine vs methadone | no estimate extracted | NR | No studies |
Days hospitalisation Morphine vs methadone | no estimate extracted | 1 study · 116 participants | Low Downgraded: imprecision |
Days treatment Morphine vs methadone | no estimate extracted | 2 studies · 147 participants | Low Downgraded: imprecision, inconsistency |
Adverse events (treatment related) To discharge Morphine vs methadone | RR 0.33 [0.01, 8.02] | 1 study · 116 participants | Low Downgraded: imprecision |
Morphine versus buprenorphine for opioid withdrawal in newborn infants
Population: newborn infants with opioid withdrawal
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Treatment failure To discharge Morphine vs buprenorphine | RR 0.79 [0.36, 1.74] | 3 studies · 113 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Seizures To discharge Morphine vs buprenorphine | RR 0.33 [0.01, 7.5] | 3 studies · 113 participants | Very low Downgraded: risk of bias, imprecision |
Neonatal or infant mortality Morphine vs buprenorphine | no estimate extracted | NR | No studies |
Neurodevelopmental disability Morphine vs buprenorphine | no estimate extracted | NR | No studies |
Days hospitalisation Morphine vs buprenorphine | no estimate extracted | 3 studies · 113 participants | Moderate Downgraded: risk of bias |
Days treatment Morphine vs buprenorphine | no estimate extracted | 3 studies · 112 participants | Moderate Downgraded: risk of bias |
Adverse events (treatment‐related) To discharge Morphine vs buprenorphine | RR 0.33 [0.01, 7.5] | 3 studies · 113 participants | Very low Downgraded: risk of bias, imprecision |
Morphine versus dilute tincture of opium for opioid withdrawal in newborn infants
Population: newborn infants with opioid withdrawal
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Treatment failure Morphine vs dilute tincture of opium | no estimate extracted | NR | No studies |
Seizures Morphine vs dilute tincture of opium | no estimate extracted | NR | No studies |
Neonatal or infant mortality Morphine vs dilute tincture of opium | no estimate extracted | NR | No studies |
Neurodevelopmental disability Morphine vs dilute tincture of opium | no estimate extracted | NR | No studies |
Days hospitalisation Morphine vs dilute tincture of opium | no estimate extracted | 1 study · 33 participants | Low Downgraded: imprecision |
Days treatment Morphine vs dilute tincture of opium | no estimate extracted | 1 study · 33 participants | Low Downgraded: imprecision |
Adverse events (treatment related) To discharge Morphine vs dilute tincture of opium | no estimate extracted | NR | No studies |
Opioid versus clonidine for opioid withdrawal in newborn infants
Population: newborn infants with opioid withdrawal
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Treatment failure To discharge Opioid vs clonidine | no estimate extracted | 1 study · 31 participants | Low Downgraded: imprecision |
Seizures Opioid vs clonidine | no estimate extracted | NR | No studies |
Neonatal or infant mortality Opioid vs clonidine | no estimate extracted | NR | No studies |
Neurodevelopmental disability Opioid vs clonidine | no estimate extracted | NR | No studies |
Days hospitalisation Opioid vs clonidine | no estimate extracted | 1 study · 31 participants | Low Downgraded: imprecision |
Days treatment Opioid vs clonidine | no estimate extracted | 1 study · 31 participants | Low Downgraded: imprecision |
Adverse events (treatment related) To discharge Opioid vs clonidine | no estimate extracted | NR | No studies |
Opioid versus diazepam for opioid withdrawal in newborn infants
Population: newborn infants with opioid withdrawal
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Treatment failure To discharge Opioid vs diazepam | RR 0.43 [0.23, 0.8] | 2 studies · 86 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Seizures To discharge Opioid vs diazepam | no estimate extracted | NR | No studies |
Neonatal or infant mortality Opioid vs diazepam | no estimate extracted | NR | No studies |
Neurodevelopmental disability Opioid vs diazepam | no estimate extracted | NR | No studies |
Days hospitalisation Opioid vs diazepam | no estimate extracted | 1 study · 34 participants | Very low Downgraded: risk of bias, imprecision |
Days treatment Opioid vs diazepam | no estimate extracted | 1 study · 33 participants | Very low Downgraded: risk of bias, imprecision |
Adverse events (treatment related) To discharge Opioid vs diazepam | no estimate extracted | NR | No studies |
Opioid versus phenobarbital for opioid withdrawal in newborn infants
Population: newborn infants with opioid withdrawal
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Treatment failure To discharge Opioid vs phenobarbital | RR 0.51 [0.35, 0.74] | 6 studies · 458 participants | Moderate Downgraded: inconsistency |
Seizures To discharge Opioid vs phenobarbital | RR 0.08 [0, 1.44] | 3 studies · 281 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Neonatal or infant mortality Opioid vs phenobarbital | no estimate extracted | NR | No studies |
Neurodevelopmental disability Opioid vs phenobarbital | no estimate extracted | NR | No studies |
Days hospitalisation Opioid vs phenobarbital | no estimate extracted | 3 studies · 166 participants | Low Downgraded: risk of bias, imprecision |
Days treatment Opioid vs phenobarbital | no estimate extracted | 6 studies · 349 participants | Low Downgraded: risk of bias, imprecision |
Adverse events (treatment related) To discharge Opioid vs phenobarbital | no estimate extracted | 1 study · 96 participants | Low Downgraded: risk of bias, imprecision |
Opioid versus chlorpromazine for opioid withdrawal in newborn infants
Population: newborn infants with opioid withdrawal
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Treatment failure To discharge Opioid vs chlorpromazine | RR 0.08 [0.01, 0.62] | 1 study · 90 participants | Moderate Downgraded: imprecision |
Seizures To discharge Opioid vs chlorpromazine | no estimate extracted | 1 study · 90 participants | Low Downgraded: imprecision |
Neonatal or infant mortality Opioid vs chlorpromazine | no estimate extracted | NR | No studies |
Neurodevelopmental disability Opioid vs chlorpromazine | no estimate extracted | NR | No studies |
Days hospitalisation Opioid vs chlorpromazine | no estimate extracted | NR | No studies |
Days treatment Opioid vs chlorpromazine | no estimate extracted | 1 study · 76 participants | Low Downgraded: risk of bias, imprecision |
Adverse events (treatment related) Opioid vs chlorpromazine | no estimate extracted | 1 study · 90 participants | Low Downgraded: imprecision |