Expert Commentary

Opiate use by U.S. mothers and increases in neonatal abstinence syndrome

2012 study in the Journal of the American Medical Association on the tripling of rates of babies affected by maternal opiate use over the past decade.

Neonatal abstinence syndrome (NAS) can occur in newborns exposed to addictive drugs while in the mother’s womb. The syndrome occurs most commonly with opiate use — from prescription painkillers to illegal drugs such as heroin — prior to and during pregnancy. According to the Substance Abuse and Mental Health Services Administration, the rate of illicit drug use among pregnant women age 18 to 25 is 7.4%, and among pregnant teens is measured as high as 16.2%.

A 2012 study from the University of Michigan and the University of Pittsburgh published in the Journal of the American Medical Association, “Neonatal Abstinence Syndrome and Associated Health Care Expenditures: United States, 2000-2009,” analyzed information on 7.4 million discharges from 4,121 hospitals in 44 states, to measure trends and costs associated with NAS over the past decade.

The study’s findings include:

  • Between 2000 and 2009, the number of mothers using opiates increased from 1.19 to 5.63 per 1,000 hospital births per year.
  • The overall rate of newborns being diagnosed with NAS tripled over the decade. In 2000, NAS was diagnosed at a rate of 1.2 per 1,000 births per year. In 2009, the rate was 3.39 per 1,000 hospital births, equivalent to 13,539 total cases. This means that, as of 2009, approximately one infant born per hour in the United States had signs of drug withdrawal.
  • Newborns with NAS were 19% more likely than all other hospital births to have low birthweight and 30% more like to have respiratory complications.
  • Mean hospital charges for births with a diagnosis of NAS increased from $39,400 in 2000 to $53,400 in 2009; 77.6% of charges for NAS were covered by state Medicaid programs.
  • Between 2000 and 2009, total hospital charges for NAS cases, adjusted for inflation, are estimated to have increased from $190 million to $720 million.

“Newborns with NAS experience longer, often medically complex and costly initial hospitalizations,” the authors conclude. “The increasing incidence of NAS and its related health care expenditures call for increased public health measures to reduce antenatal exposure to opiates across the United States.”

Tags: children, parenting, drugs, addiction

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