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Updated: Dec 21, 2025

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Subclinical and Overt Newborn Opioid Exposure: Prevalence and First-Year Healthcare Utilization

Zana Percy1, Cole Brokamp2, Jennifer M McAllister3

  • 1Medical Scientist Training Program, University of Cincinnati College of Medicine, Cincinnati, OH; Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH.

The Journal of Pediatrics
|May 20, 2020
PubMed

Insights

Newborn opioid exposure, even without neonatal abstinence syndrome (NAS), increases first-year healthcare use. This study tracked opioid-exposed infants in Ohio, revealing significant healthcare utilization and costs associated with fetal opioid exposure.

Area of Science:

  • Neonatal Health
  • Public Health
  • Pharmacology

Background:

  • Opioid use during pregnancy presents significant risks to newborns.
  • Understanding the healthcare utilization patterns of infants with varying degrees of fetal opioid exposure is crucial for resource allocation and care planning.

Purpose of the Study:

  • To categorize newborn infants based on fetal opioid exposure status.
  • To assess the first-year healthcare utilization of these infants.

Main Methods:

  • A population-based cohort of 41,136 live births from 2014-2017 in Hamilton County, Ohio, was analyzed.
  • Infants were classified as unexposed, exposed with neonatal abstinence syndrome (NAS), or subclinically exposed.
  • Healthcare encounters in the first year of life were evaluated using electronic health records.

Main Results:

  • The prevalence of newborn opioid exposure was 37 per 1000 births.
  • Subclinical opioid exposure was linked to longer birth encounters and increased odds of hospitalization in the first year.
  • Infants with NAS experienced significantly longer hospital stays compared to unexposed infants.

Conclusions:

  • Both subclinical and overt fetal opioid exposure are associated with increased healthcare utilization in the first year of life.
  • The estimated cost to the Hamilton County healthcare system for longer birth encounters alone was over $1.1 million between 2014 and 2017.
Abstract

Keywords:
cohortpregnancysubstance abuse

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