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Increased Incidence of Urinary Tract Infections in Newborns With Neonatal Opiate Withdrawal Syndrome Treated With Morphine and Clonidine: A Case Series With Supplemental Descriptive Cohort Data

A. Richmond, M. C. Smith, Micah Butcher, Lesley Cottrell, M. Polak

Case Reports in Pediatrics, 2026

Abstract

Neonatal opioid withdrawal syndrome has become a prevalent diagnosis with the rise of maternal substance use during pregnancy. Manifestation of this syndrome is characterized by altered activity of the central nervous system with symptoms including irritability, gastrointestinal dysfunction, and activation of the autonomic nervous system. There is currently no standardized pharmacological protocol for the treatment of this syndrome. Opioids such as morphine and methadone are first‐line medications with clonidine as the recommended adjunct therapy. We observed increases in urinary tract infection in infants, especially male infants, with neonatal opioid withdrawal syndrome that were treated with morphine and clonidine. Urinary tract infection is uncommon among newborns and poses a significant risk to their health secondary to their immature renal and immune systems. We describe 4 cases in newborns treated with morphine and clonidine, prompting an investigation into the individual cases to highlight a potential association between clonidine exposure and urinary tract infection.

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Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.

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