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Public health approach needed to curb incidence of neonatal abstinence syndrome in US
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The incidence for the postnatal opioid withdrawal syndrome — known as neonatal abstinence syndrome — increased almost five-fold in the U.S. between 2000 and 2012 and accounted for an estimated annual $1.5 billion in hospital expenditures, according to study results.
“This costly health problem merits a public health approach to alleviate harm to women and children,” Stephen W. Patrick, MD, MPH, MS, assistant professor of pediatrics and health policy in the department of pediatrics at Vanderbilt University School of Medicine, and colleagues wrote.
For the study, Patrick and colleagues gathered diagnostic and demographic data on hospital discharges that occurred between 2009 and 2012 from the Kids’ Inpatient Database and the Nationwide Inpatient Sample. Neonatal abstinence syndrome-associated diagnoses were then identified and expenditure data were adjusted to 2012 U.S. dollars.
Between 2009 and 2012, there were a total of 21,732 infants diagnosed with neonatal abstinence syndrome. Incidence increased from 3.4 per 1,000 hospital births (95% CI, 3.2-3.6) to 5.8 per 1,000 hospital births (95% CI, 5.5-6.1).
There was an increase in aggregate hospital charges for neonatal abstinence syndrome from $732 million to $1.5 billion (P < .001), of which 81% were attributed to state Medical programs during 2012.
Compared with the lowest incidence rate of 2.6 (95% CI, 2.3-2.9) in the West South Central Division of Oklahoma, Texas, Arkansas and Louisiana, the rate was 16.2 (95% CI, 12.4-18.9) in the East South Central Division of Kentucky, Tennessee, Mississippi and Alabama.
“Federal and state policymakers should be mindful of the impact the [opioid pain reliever] epidemic continues to have on pregnant women and their infants, and consider these vulnerable populations in efforts aimed at primary prevention,” Patrick and colleagues wrote. “Finally, efforts aimed at primary prevention and treatment improvements should be targeted at the most affected areas of the country.”
Disclosure: The researchers report no relevant financial disclosures.
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