517 Racial differences in modified finnegan neonatal abstinence scoring for neonatal opioid withdrawal syndrome

Neonates exposed in-utero to opioids are commonly evaluated for neonatal opioid withdrawal syndrome (NOWS) using modified Finnegan Neonatal Abstinence Scoring System (FNASS). FNASS includes 21 different components of central nervous system, metabolic, vasomotor, respiratory, and GI disturbances. Consecutive cumulative scores ≥8 suggestive starting pharmacologic treatment. Our objective was identify significant differences in scoring neonates stratified by race. Retrospective cohort study patients with use disorder (OUD) who received co-located prenatal addiction care from 2013 2020 at a large academic institution. Non-Hispanic Black (NHB) were matched non-Hispanic White (NHW) year gestational age delivery. Race ethnicity self-reported the mother. The primary outcome individual components. 42 NHB mother-newborn dyads compared NWH dyads. There no baseline demographics between groups. newborns significantly less likely than NHW be scored observed red, blotchy skin changes consistent mottling (79% vs 100%, P<0.01). All mild tremors when disturbed increased muscle tone; there remaining receive (69% vs. 81%, RR 0.85, CI 0.66-1.09) infants, pharmacological treatment NOWS (76% 98%, 0.78, 0.66-0.93) newborns. However, within this newborns, receiving score would have resulted earlier and/or rates 36% (n=15) patients. Infants born on FNASS. Lack recognition maybe due pigmentation could potentially result underscoring delay NOWS.