TABLE 2.

CSTE NAS Case Definition Classification Criteria

Criterion	Confirmed	Probable		Suspect
		Type		Type
		1	2	1	2	3	4	5
Neonate
Infant laboratory test result positive for opiates, benzodiazepines, or barbiturates	X	—	—	—	—	—	—	—
No or unknown infant laboratory test results	—	X	X	X	X	X	X	X
Diagnosis of NAS, chief complaint of NAS, or ≥3 signsa of neonate withdrawal	X	X	X	X	X	X	—	—
One or 2 signs of neonate withdrawal	—	—	—	—	—	—	X	X
Absence of another known cause or diagnosisb	X	X	X	X	X	X	X	X
Maternal
Maternal laboratory test result positive for opiates, benzodiazepines, or barbiturates within 4 wk of delivery	—	—	X	—	—	—	—	X
Maternal laboratory test result positive for nonopiate, nonbenzodiazepine, and nonbarbiturate drug of abuse within 4 wk of delivery	—	—	—	—	—	X	—	—
No or unknown maternal laboratory test results	—	—	—	X	X	—	X	—
Maternal history of chronic opioid use, benzodiazepine, or barbiturate within 4 wk of delivery	—	X	—	—	—	—	X	—
Maternal history of chronic drug use within 4 wk of delivery (nonopioid, nonbenzodiazepine, and nonbarbiturate)	—	—	—	X	—	—	—	—
Maternal history of chronic drug use within 4 wk of delivery (unknown drug type)	—	—	—	—	X	—	—	—

Adapted from Council of State and Territorial Epidemiologists. Neonatal Abstinence Syndrome Standardized Case Definition. Atlanta, GA: Council of State and Territorial Epidemiologists; 2019:19–21. Available at: https://cdn.ymaws.com/www.cste.org/resource/resmgr/2019ps/final/19-MCH-01_final_7.31.19.pdf. X, mandatory requirement for case definition type; —, not applicable.

^bInfant withdrawal signs: high-pitched cry, hypertonia, myoclonus, hyperactive Moro reflex, poor sleep, poor feeding, frequent yawning, nasal congestion, sneezing, fever, cutaneous mottling, vomiting, loose stools, seizures, and tachypnea.

^cNo current exclusion list for other etiologies.