Neonatal Abstinence Syndrome and Maternal Substance Use in Wisconsin, 2009-2014

Increasing rates of neonatal abstinence syndrome (NAS), most commonly linked to maternal opioid use, are a growing concern within clinical and public health domains.

The study aims to describe the statewide burden of NAS and maternal substance use, focusing on opioids in Wisconsin from 2009 to 2014.

Trends in NAS and maternal substance use diagnosis rates were calculated using Wisconsin’s Hospital Discharge Data. Demographic and payer characteristics, health service utilization, and clinical outcomes were compared for newborns with and without NAS. Demographic and payer characteristics were compared between women with and without substance use identified at time of delivery.

Rates of NAS and maternal substance use, most notably opioid use, increased significantly between 2009 and 2014. The majority of newborns diagnosed with NAS, and women identified with substance use, were non-Hispanic, white, and Medicaid-insured. Disproportionate rates of NAS and maternal opioid use were observed in American Indian/Alaska Native and Medicaid populations compared to white and privately insured groups, respectively. Women age 20-29 years had the highest rates of opioid use compared to the reference group (10-19 years). Odds of adverse clinical outcomes and levels of health service utilization were significantly higher for newborns with NAS.

Similar to trends nationally, our findings show an increase in maternal opioid use and NAS rates in Wisconsin over time, with disproportionate effects in certain demographic groups. These findings support the need for targeted interventions in clinical and public health settings aimed at prevention and burden reduction of NAS and maternal substance use in Wisconsin.