Neonatal Abstinence Syndrome due to In-utero Exposure to Gabapentin: A Case Report

We report the case of a neonate who likely developed symptoms of Neonatal Abstinence Syndrome after in-utero exposure to gabapentin for treatment of maternal chronic pain. The neonate developed symptoms of hypertonicity, tremor, and poor feeding twelve hours after delivery. Although the neonate wasbriefly exposed to the benzodiazepine alprazolam and the opioid oxycodone, the withdrawal symptoms were not characteristic of opioid or benzodiazepine withdrawal, such as hyperphagia, vomiting and loose stools. Due to a high suspicion of gabapentin withdrawal, the neonate was successfully treated with gabapentin and clonidine. Neonatal abstinence syndrome from gabapentin has been reported in the past [1] but in each of the reports the diagnosis has been questioned due to the prolonged maternal use of multiple other agents. We present a case with distinctly different symptoms of NAS after maternal exposure to gabapentin with discussion of the diagnosis, treatment and management of these neonates.