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Health Services Use Among Children With Prenatal Substance Exposure or Neonatal Abstinence Syndrome

Kristina D West1, Mir M Ali1, Brenda Natzke1

  • 1Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services, Washington, D.C. (West, Ali); Mathematica, Washington, D.C. (Natzke, Nguyen).

Psychiatric Services (Washington, D.C.)
|September 15, 2023
PubMed

Insights

Infants exposed to substances before birth or with neonatal abstinence syndrome (NAS) used more mental health services and psychotropic medication. These patterns were observed through age five, underscoring the need for early intervention.

Area of Science:

  • Pediatrics
  • Neonatal Care
  • Mental Health Services Research

Background:

  • Infants with prenatal substance exposure or neonatal abstinence syndrome (NAS) exhibit higher overall healthcare utilization.
  • Limited data exists regarding the specific mental health service utilization and psychotropic medication use in this vulnerable infant population.

Purpose of the Study:

  • To investigate the patterns of mental health service use and psychotropic medication among infants with prenatal substance exposure or NAS.
  • To compare mental health service use between infants with and without prenatal substance exposure or NAS.

Main Methods:

  • A large cohort study of over 1 million infants born in 2016 across 38 states.
  • Utilized Medicaid and Children's Health Insurance Program data, identifying exposure/NAS through ICD-10 codes and tracking service use via procedure and revenue codes.
  • Followed infants through their fifth year of life.

Main Results:

  • Infants with prenatal substance exposure or NAS demonstrated higher rates of mental health visits compared to their peers.
  • Psychotropic medication use was also more prevalent in infants with prenatal substance exposure or NAS.
  • These disparities in mental health service utilization persisted across most of the 5-year study period.

Conclusions:

  • Elevated mental health service use in infants with prenatal substance exposure or NAS highlights critical needs for early identification.
  • The findings support the implementation of early screening protocols for this population.
  • Early engagement in school-based mental health interventions is crucial for addressing the observed needs.
Abstract

Keywords:
MedicaidNeonatal abstinence syndromeOpioidsServices

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