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Could prenatal food insecurity influence neonatal abstinence syndrome severity?

Ruth Rose-Jacobs1, Michelle Trevino-Talbot2, Christine Lloyd-Travaglini3

  • 1Pediatrics, Boston University School of Medicine and Boston Medical Center, Boston, MA, USA.

Addiction (Abingdon, England)
|November 14, 2018
PubMed

Insights

Prenatal food insecurity in pregnant women receiving opioid treatment is linked to a higher risk of their infants needing medication for neonatal abstinence syndrome (NAS). This highlights a critical connection between maternal nutrition and infant health outcomes.

Area of Science:

  • Obstetrics and Gynecology
  • Neonatal Health
  • Public Health Nutrition

Background:

  • Prenatal food insecurity is a known risk factor for adverse maternal and infant health outcomes.
  • Opioid use disorder during pregnancy, often treated with opioid agonist therapy, presents unique challenges for maternal and infant well-being.
  • Neonatal Abstinence Syndrome (NAS) is a significant concern for infants exposed to opioids in utero.

Purpose of the Study:

  • To investigate the association between prenatal food insecurity and the severity of neonatal abstinence syndrome (NAS) in infants born to mothers receiving opioid agonist treatment.
  • To determine if maternal food insecurity predicts the need for pharmacological treatment for NAS.
  • To explore the relationship between prenatal food insecurity and the length of hospital stay for NAS management.

Main Methods:

  • A prospective cohort study was conducted at a large urban safety-net hospital.
  • Participants included 75 pregnant women receiving opioid agonist treatment (methadone or buprenorphine) during their third trimester.
  • Food insecurity was assessed using a validated screener, and NAS severity was measured by the extent of pharmacological treatment and length of hospital stay, with data abstracted from medical records.

Main Results:

  • A significant proportion of infants (81%) required pharmacological treatment for NAS, with a mean hospital length of stay of 19.9 days.
  • Maternal food insecurity was associated with an increased risk of infant NAS pharmacological treatment, even after adjusting for maternal depression and methadone treatment.
  • The association between food insecurity and the length of hospital stay for NAS was inconclusive.

Conclusions:

  • Prenatal food insecurity appears to be a significant risk factor associated with an increased likelihood of infants requiring pharmacological treatment for neonatal abstinence syndrome among women undergoing opioid agonist treatment.
  • These findings underscore the importance of addressing food insecurity in pregnant women with opioid use disorder to potentially mitigate NAS severity.
  • Further research is warranted to explore the mechanisms linking food insecurity to NAS severity and to develop targeted interventions.
Abstract

Keywords:
Food insecurityNASin-utero opioid exposureneonatal abstinence syndromeopioid use disorderpregnancyprenatal depressive symptoms

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