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Updated: Jan 21, 2026

Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography
Published on: January 27, 2023
Racial association and pharmacotherapy in neonatal opioid withdrawal syndrome
Abhinav Parikh1, Mathangi Gopalakrishnan2, Ahad Azeem3
1University of Maryland Medical Center, Baltimore, MD, USA. abhinavparikh@gmail.com.
Objective:
To determine if racial differences are associated with Neonatal Opioid Withdrawal Syndrome (NOWS) severity.
Study Design:
A 10-year (2008-2017) retrospective cohort of infants ≥35 weeks gestation with prenatal exposure to opioids was included. The primary measure was the need for pharmacotherapy. Multivariable logistic regression and propensity score analysis were performed.
Results:
Among 345 infants with NOWS, 111 (32%) were black infants with 70% of them requiring pharmacotherapy as compared with 84% of white infants. Upon adjusting for significant covariates (methadone, benzodiazepine use, and gestational age), black infants were 57% less likely than whites to require pharmacotherapy (Odds ratio: 0.43, 95%CI: 0.22-0.80, p = 0.009). Similar results were observed with propensity score analysis.
Conclusions:
Significant racial disparity observed may be secondary to genetic variations in opioid pharmacogenomics and/or extrinsic factors. Large-scale studies are warranted to include race in predictive models for early pharmacological intervention.
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