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Skin conductance in neonates suffering from abstinence syndrome and unexposed newborns

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Abstract

The aims of this study were to compare the skin conductance (SC) of newborns with opiate-induced neonatal abstinence syndrome (NAS) to that of unexposed newborns and to evaluate the potential of SC readings to detect distress in the context of NAS objectively. The SC of 12 newborns with NAS and 12 unexposed newborns was measured at nine specific times during their first 6 weeks of life. The number of SC fluctuations per second (NSCF/s), the amplitude of SC fluctuation, and the mean level of SC were recorded and analyzed. The SC of newborns treated for symptoms of NAS differed significantly from the SC of unexposed newborns with regard to the NSCF/s (p = 0.04). With the mean level of SC, we observed an interaction between groups over time (p value for interaction = 0.02). With increasing postnatal age, we observed higher values in all three SC parameters.

Conclusion: The NSCF/s and the mean level of SC appear to be suitable to reflect the distress of newborns suffering from NAS. As it is known that the sensitivity of SC increases with the level of stress experienced, its potential to indicate elevated stress levels in infants with NAS should be investigated in future studies evaluating different therapy regimens.

What is Known:

• Skin conductance is a result of the filling of palmar and plantar sweat glands innervated by the sympathetic nervous system

• Skin conductance can be used as a measure of stress and pain in newborns

What is New:

• Skin conductance of newborns with neonatal abstinence syndrome (NAS) differs significantly from the SC of non-substance-exposed newborns during the first 6 weeks of life

• Skin conductance appears to reflect the increased distress of infants with NAS

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Abbreviations

ASCF:

Amplitude of skin conductance fluctuations

BPSN:

Bernese Pain Scale for Neonates

CI:

Confidence interval

DTO:

Diluted tincture of opium

NAS:

Neonatal abstinence syndrome

NSCF/s:

Number of skin conductance fluctuations per second

SC:

Skin conductance

μS:

Microsiemens

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Acknowledgments

First of all, we would like to thank the newborns and their families. Thank you for making this study possible through your engagement, your trust, and the time you invested. It was our pleasure to accompany you during the first 6 weeks of your life, and we wish you all the best for the future. Thanks to Georgina Mangan-Georgiou for her linguistic advice and support. Thanks to Dr. F. Schäfer, K. Becker, and Dr. F. Link for their advice regarding SC. Moreover, sincere thanks to Dr. A. Kribs, Dr. S. Fahl, Dr. H. Wiedemann, and Dr. P. Gudowius for actively supporting this study within the clinical routine. Thanks to many nurses for being patient with us and for allowing our measurements to interrupt their work. Thanks to the Maria-Pesch-Foundation (Medical Faculty, University of Cologne) for financially supporting our research equipment.

Contribution of the authors and co-authors

Nicola Elisabeth Schubach, Christoph Hünseler, Katrin Mehler, and Bernhard Roth planned the study, wrote the study protocol, supervised the study, analyzed the data, and wrote the manuscript draft. Nicola Elisabeth Schubach performed all the measurements. Echhard Korsch, Rainhard Laux, Dominique Singer, and Axel von der Wense critically reviewed and edited the study protocol and the manuscript and recruited patients for the study. András Treszl did the statistical analysis.

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Authors and Affiliations

  1. Neonatology and Pediatric Intensive Care, Children’s Hospital of the University of Cologne, Kerpener Str. 34, 50931, Cologne, Germany

    Nicola Elisabeth Schubach, Katrin Mehler, Bernhard Roth & Christoph Hünseler

  2. Children’s Hospital Agaplesion Diakonieklinik Rotenburg, Elise-Averdieck-Straße 17, 27356, Rotenburg (Wümme), Germany

    Nicola Elisabeth Schubach

  3. Children’s Hospital of the City of Cologne, Amsterdamerstrasse 59, 50735, Cologne, Germany

    Eckhard Korsch

  4. Neonatology and Pediatric Intensive Care, Asklepios Klinik Barmbek, Hamburg, Rübenkamp 220, 22291, Hamburg, Germany

    Rainhard Laux

  5. Neonatology and Pediatric Intensive Care, University Children’s Hospital Hamburg-Eppendorf, Martinistraße 52/N23, 20246, Hamburg, Germany

    Dominique Singer

  6. Neonatology and Pediatric Intensive Care, Altonaer Children’s Hospital, Altonaer Kinderkrankenhaus, Bleickenallee 38, 22763, Hamburg, Germany

    Axel von der Wense

  7. Department of Medical Biometry and Epidemiology, Center for Experimental Medicine, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany

    András Treszl

Authors
  1. Nicola Elisabeth Schubach
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  2. Katrin Mehler
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  6. Dominique Singer
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  7. Axel von der Wense
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  9. Christoph Hünseler
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Corresponding author

Correspondence to Christoph Hünseler.

Ethics declarations

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Conflict of interest

All authors declare that they have no conflict of interest. All authors moreover indicate that they have no financial relationship with the organization that sponsored the research.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Communicated by Patrick Van Reempts

Revisions received: 8 December 2015; 10 February 2016; 15 March 2016

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Schubach, N.E., Mehler, K., Roth, B. et al. Skin conductance in neonates suffering from abstinence syndrome and unexposed newborns. Eur J Pediatr 175, 859–868 (2016). https://doi.org/10.1007/s00431-016-2716-8

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  • DOI: https://doi.org/10.1007/s00431-016-2716-8

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