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Association Between Clubfoot and Neonatal Abstinence Syndrome in the United States, 2018-2022

Meera M Dhodapkar1, Anshu Jonnalagadda, Adrienne R Socci

  • 1Yale Department of Orthopaedics and Rehabilitation, New Haven, CT.

Journal of Pediatric Orthopedics
|August 30, 2024
PubMed

Insights

Infants diagnosed with neonatal abstinence syndrome (NAS) have increased odds of clubfoot. This association persists even after accounting for sociodemographic factors and comorbidity burden, highlighting a critical link in pediatric health.

Area of Science:

  • Pediatric Health
  • Neonatal Care
  • Orthopedics

Background:

  • The opioid epidemic has led to a significant increase in neonatal abstinence syndrome (NAS) incidence.
  • NAS is associated with various congenital conditions, prompting further investigation into co-occurring diagnoses.

Purpose of the Study:

  • To investigate the association between neonatal abstinence syndrome (NAS) and clubfoot in neonates.
  • To identify factors influencing the co-occurrence of NAS and clubfoot.

Main Methods:

  • Retrospective analysis of the Pediatric Hospital Information System (PHIS) database from 2018-2022.
  • Identification of neonates with NAS and clubfoot using ICD-9 and ICD-10 codes.
  • Univariable and multivariable logistic regression analyses were performed.

Main Results:

  • A total of 458,274 neonates were analyzed; 0.5% had clubfoot and 1.2% had NAS.
  • Patients with NAS showed higher odds of clubfoot (OR: 1.49).
  • Increased odds of clubfoot were also associated with higher comorbidity burden, greater gestational age, and longer length of stay. Lower odds were observed in Asian, Hispanic/Latino, non-Hispanic Black, and multiracial populations compared to non-Hispanic White patients.

Conclusions:

  • Neonatal abstinence syndrome (NAS) is independently associated with an increased likelihood of clubfoot.
  • Comorbidity burden and certain sociodemographic factors also play a role in the association between NAS and clubfoot.
Abstract

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