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Maternal opioid exposure, neonatal abstinence syndrome, and infant healthcare utilization: A retrospective cohort

Jean Y Ko1, Jangho Yoon2, Van T Tong3

  • 1Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, USA; United States Public Health Service, Commissioned Corps, Rockville, MD, USA.

Drug and Alcohol Dependence
|April 24, 2021
PubMed

Insights

Infants exposed to opioids in utero or with neonatal abstinence syndrome (NAS) experienced significantly higher healthcare use. Early interventions are crucial to reduce hospitalizations and improve infant health outcomes.

Area of Science:

  • Neonatal Health
  • Public Health
  • Pharmacology

Background:

  • Maternal opioid use during pregnancy is a growing public health concern.
  • Neonatal Abstinence Syndrome (NAS) is a recognized consequence of prenatal opioid exposure.
  • Understanding the healthcare utilization patterns of affected infants is critical for resource allocation and care planning.

Purpose of the Study:

  • To quantify and compare healthcare utilization among infants based on maternal opioid exposure and NAS status.
  • To identify specific healthcare services with increased utilization in exposed or affected infants.
  • To provide data supporting the development of targeted interventions for this vulnerable population.

Main Methods:

  • A longitudinal cohort study of 81,833 maternal-infant dyads in Oregon (2008-2012) using linked birth and Medicaid data.
  • Infants categorized into four groups: Opioid+/NAS+, Opioid+/NAS-, Opioid-/NAS+, and Opioid-/NAS- based on ICD-9-CM codes and prescription records.
  • Modified Poisson regression used to calculate adjusted risk ratios (aRR) for healthcare utilization, comparing exposed/affected infants to unexposed/unaffected infants.

Main Results:

  • Maternal opioid exposure prevalence was 123.1 per 1000 dyads; NAS incidence was 5.8 per 1000 dyads.
  • Infants with maternal opioid exposure showed significantly higher hospitalization rates within 4 weeks and 1 year postpartum compared to controls.
  • Both maternal opioid exposure and NAS were associated with increased sick visits and emergency department (ED) visits in the year following birth.

Conclusions:

  • Infants with NAS and/or maternal opioid exposure demonstrate substantially greater healthcare utilization.
  • There is a clear need for interventions aimed at reducing hospitalization risks for these infants.
  • Promoting preventative services in the first year of life is essential to improve long-term health outcomes for infants affected by maternal opioid exposure.
Abstract

Keywords:
HealthcareInfantMedicaidNeonatal abstinence syndromeOpioidsPregnancy

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