Efficacy and Outcomes of a Non-Pharmacological Intervention for Neonatal Abstinence Syndrome

May 30, 2025 updated by: Elisabeth B Salisbury

A Randomized Controlled Study of Stochastic Vibrotactile Stimulation for Neonatal Abstinence Syndrome: Therapeutic Efficacy and Neurobehavioral Outcomes

The purpose of this study is to examine the efficacy of a specially-constructed crib mattress that delivers gentle vibrations (stochastic vibrotactile stimulation) as a complementary, non-pharmacological intervention for treating drug withdrawal in newborns exposed to opioids in utero.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

This study will test the therapeutic efficacy of stochastic vibrotactile stimulation (SVS) for reducing withdrawal symptoms, pharmacological treatment and hospitalization, and for improving neurobehavioral developmental outcomes in opioid-exposed newborns.

Candidates at-risk for NAS due opioid exposure in utero will be identified to investigators by medical caregiver and/or prescreened using HIPAA Waiver for recruitment (maternal-prenatal; infant-postnatal). Infants will be randomized into either SVS (complementary to standard of care) or Treatment as Usual (TAU), restricted by equipment (mattress) availability. Infants will be enrolled and assigned to a condition within 48 hours post birth and participate throughout hospitalization. Infants assigned SVS will receive daily intervention of continuous intervals of SVS throughout hospitalization using a specially constructed crib mattress that delivers gentle vibrations at preset intervals.

Specific Aim 1. Determine the efficacy of SVS as a non-pharmacological therapy complementary to standard of care for reducing severity and duration of opioid withdrawal in newborns compared to TAU alone. Quantify clinical variables: NAS severity, treatment days, days in hospital, velocity of weight gain, cumulative morphine dose.

Specific Aim 2. Compare neurobehavioral outcomes in fetal drug-exposed infants between infants who received SVS and those who received TAU. Longitudinal outcomes assessment at 6-months and 1 year to test whether early intervention with SVS compared to standard care improves physical, social, emotional and cognitive development.

Study Type

Interventional

Enrollment (Actual)

208

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • Pennsylvania
      • Pittsburgh, Pennsylvania, United States, 15213
        • University of Pittsburgh School of Medicine

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

1 hour to 1 year (Child)

Accepts Healthy Volunteers

No

Description

Inclusion Criteria: Eligible subjects are infants currently in the NICU or Newborn Nursery at University of Massachusetts Memorial Hospital or at Magee Women's Hospital of UPMC and:

  • Full-term infants (≥37 wks gestational age)
  • Newborns at risk for NAS due to opioid-exposure in utero
  • At-risk infants will be infants who present with confirmed meconium and/or urine toxicology report and/or documented medical record for opioids (e.g., methadone, buprenorphine/subutex, oxycodone, heroin); may also have prenatal exposure to benzodiazepines, barbiturates, amphetamines, cannabinoids, alcohol, nicotine and/or caffeine.

Exclusion Criteria: Eligible infants meeting the inclusion criteria above will be excluded from participation in the study if he/she:

  • Born less than <37weeks.
  • Has a clinically significant congenital abnormality
  • Has a clinically significant fetal anomaly
  • Has hydrocephalus or intraventricular hemorrhage >grade 2
  • Has a seizure disorder not related to drug withdrawal
  • Has a clinically significant cardiac shunt
  • Has anemia (hemoglobin<8g/dL)
  • Requires mechanical respiratory support
  • Has MRSA or infection at time of the study

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Stochastic Vibrotactile Stimulation (SVS)
Infants randomized to this arm will receive daily intervals of continuous SVS (ON) and no SVS (OFF) throughout hospitalization, starting within 48-hrs post birth. SVS will be complementary to standard of clinical care (e.g., clinically-determined pharmacological management; routine parental/volunteer holding; breast and/or bottle feed).
Infant crib mattress will be replaced with a specially constructed mattress (non-commercially available) to provide gentle, stochastic vibration during mattress stimulations.
No Intervention: Treatment as Usual (TAU)
Infants randomized to this arm will be enrolled within 48-hours post birth and receive treatment as usual (TAU)- standard of clinical care (e.g., clinically-determined pharmacological management, routine/volunteer holding; breast and/or bottle feed). Infants will not receive any SVS.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Number of Participants Administered Morphine Treatment
Time Frame: Participants will be monitored for the duration of their newborn nursery stay, which is an expected mean of 7 days

Number of infants treated with morphine (first line pharmacotherapy at both sites).

Number of infants who received pharmacotherapy (met clinical criteria to treat), index of NAS severity (per Finnegan scores).

Participants will be monitored for the duration of their newborn nursery stay, which is an expected mean of 7 days
Cumulative Pharmacological Treatment- Morphine Dose
Time Frame: Participants will be monitored for the duration of their hospitalization, which is an expected mean of 21 days
Normalized cumulative morphine dose for infants who completed treatment at respective hospital site (mg/kg).
Participants will be monitored for the duration of their hospitalization, which is an expected mean of 21 days
Hospitalization Length of Stay
Time Frame: Day of life infants discharged home, which is an expected mean of 21 days.

Day of life discharged home for untreated and treated infants who completed hospitalization at study site.

Duration of infant hospitalization-Days

Day of life infants discharged home, which is an expected mean of 21 days.
Hospitalization Length of Stay for Untreated Infants
Time Frame: Day of life untreated infants discharged home, which is an expected mean of 21 days.

Day of life discharged home for untreated infants (infants whose Finnegan scores did not meet criteria to treat) who completed hospitalization at study site.

Duration of infant hospitalization-Days

Day of life untreated infants discharged home, which is an expected mean of 21 days.
Hospitalization Length of Stay for Treated Infants
Time Frame: Day of life treated infants discharged home, which is an expected mean of 21 days.

Day of life discharged home for treated infants (infants whose Finnegan scores met criteria to treat) who completed hospitalization at study site.

Duration of infant hospitalization-Days

Day of life treated infants discharged home, which is an expected mean of 21 days.
Length of Pharmacological Treatment-Duration
Time Frame: Participants will be monitored for the duration of their hospitalization, which is an expected mean of 21 days
For infants who received pharmacotherapy, total days of morphine treatment.
Participants will be monitored for the duration of their hospitalization, which is an expected mean of 21 days
Trajectory of Symptom Severity Among Treated Infants
Time Frame: Day of life infant started morphine treatment
Days to start morphine treatment based on Finnegan severity scores among infants who met clinical criteria to treat
Day of life infant started morphine treatment
Velocity of Weight Gain
Time Frame: Participants will be monitored for the duration of their hospitalization, which is an expected mean of 21 days
Weight loss precedes weight gain in newborns. Days to weight nadir, defined as the lowest weight following birthweight. Velocity of weight gain was measured as days to return to birthweight, i.e., the day on which weight reached or surpassed birthweight following initial weight loss from birth.
Participants will be monitored for the duration of their hospitalization, which is an expected mean of 21 days
Neurobehavioral Outcomes Assessment
Time Frame: 6 month and 12 months of life
Scores for Cognitive Domain Bayley Scales of Infant and Toddler Development Third Edition. The standardized scores have a mean of 100 and standard deviation (SD) of 15. Scores below 1 SD (= or less than 84) is considered below normal. Scores above 1 SD (>115) represent higher than normal functioning.
6 month and 12 months of life

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Velocity of weight gain
Time Frame: Participants will be monitored for the duration of their hospitalization, which is an expected mean of 21 days
Trajectory of weight gain throughout hospitalization-Days to return to birth weight
Participants will be monitored for the duration of their hospitalization, which is an expected mean of 21 days
Hospitalization length of stay
Time Frame: Participants will be monitored for the duration of their hospitalization, which is an expected mean of 21 days
Duration of infant hospitalization
Participants will be monitored for the duration of their hospitalization, which is an expected mean of 21 days

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
Respiratory Rate
Time Frame: Assess respiratory rate for about 12 consecutive hours at week 1 of infant hospitalization
Respiratory rate at 1 week of age assessed for about 12 consecutive hours in a subset of subjects
Assess respiratory rate for about 12 consecutive hours at week 1 of infant hospitalization

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Collaborators

Investigators

  • Principal Investigator: Elisabeth B Salisbury, Ph.D., University of Pittsburgh

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

March 9, 2017

Primary Completion (Actual)

March 5, 2021

Study Completion (Actual)

June 6, 2021

Study Registration Dates

First Submitted

June 9, 2016

First Submitted That Met QC Criteria

June 9, 2016

First Posted (Estimated)

June 15, 2016

Study Record Updates

Last Update Posted (Actual)

June 11, 2025

Last Update Submitted That Met QC Criteria

May 30, 2025

Last Verified

May 1, 2025

More Information

Terms related to this study

Other Study ID Numbers

  • STUDY21040054
  • 1R01DA042074-01 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

Yes

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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