Which condition is associated with opioid exposure in newborns?

• A. Neonatal jaundice
• B. Neonatal respiratory distress syndrome
• C. Neonatal abstinence syndrome
• D. Neonatal hypothyroidism

Answer: (C)

Opioid exposure in newborns can lead to withdrawal after birth, called neonatal abstinence syndrome. When a fetus is exposed to opioids, it becomes physically dependent; after birth, the absence of the drug triggers withdrawal symptoms. You’ll see CNS hyperarousal and autonomic instability plus gastrointestinal issues—for example, irritability, a high-pitched cry, tremors, sleep problems, yawning, sneezing, sweating, poor feeding, vomiting, diarrhea, and rapid breathing. The timing depends on the specific opioid’s duration, but symptoms often begin within 24–72 hours for short-acting opioids and may be delayed with longer-acting ones. Management focuses on careful assessment (often with a NAS scoring system), providing supportive care (quiet environment, swaddling, small, frequent feeds, hydration), and, in more severe cases, pharmacologic treatment with opioid replacement (like morphine or methadone) while gradually weaning off. The other conditions listed are not specifically tied to opioid exposure: neonatal jaundice relates to bilirubin processing, neonatal respiratory distress syndrome to surfactant deficiency in preterm infants, and neonatal hypothyroidism to thyroid hormone deficiency. Neonatal abstinence syndrome is the most direct consequence of opioid exposure in utero.