Safety, Tolerability, and Efficacy of Acupuncture in Management of Neonatal Abstinence Syndrome (NAS): A Systematic Review

Background: The Neonatal Abstinence Syndrome (NAS) has been treated so far by various drugs, such as opioids and non-opioids. There is some concern about NAS babies who receive chemical drug treatment. Some researchers mentioned that shorter pharmacological treatment and less lengthy hospitalization are associated with several secondary advantages. The aim of this study was to assess safety, tolerability, and efficacy of acupuncture in management of Neonatal Abstinence Syndrome in infants.   Materials and Methods: An extensive search was done in databases of Medline, EMBASE, Scopus, Cochrane, and Web of Science until August 2018. Two independent researchers screened articles, in the next step, full texts of probably relevant articles were summarized and categorized based on the evaluated outcomes and overall effect size was presented. Results: Five studies were included in the systematic review. Auricular acupuncture when implemented as adjunct pulse non pharmacologic in management of NAS is safe, feasible, and acceptable. However, Auricular acupressure did not show any significant effect on pharmacological therapy, length of hospital stay and average NAS scores. Treatment with Laser acupuncture as adjunct in management of infants with NAS were associated with several advantages. These include improvement in feeling (better relaxation and higher calorie intake), decreased Finnegan scores, shorter duration of treatment with morphine, and shorter duration of hospitalization. In terms of safety, treatment with laser acupuncture as adjunctive were well-tolerated. Conclusion: The findings of this systematic review showed that infants with NAS secondary to maternal opiate usage may receive more benefits of treatment with acupuncture in combination with pharmacologic therapy compared to pharmacologic therapy alone. In these findings should be interpreted in light of mentioned limitation.