This article is more than 5 years old. Information may no longer be current.

Neonatal abstinence syndrome rates increased 300% among 28 states

The overall prevalence of neonatal abstinence syndrome increased by 300% in 28 states with publicly available data from 1999 to 2013, highlighting the importance of state-based public health programs to prevent unnecessary opioid use, and to treat substance use disorders during pregnancy, according to data published in Morbidity and Mortality Weekly Report.

“[Neonatal abstinence syndrome (NAS)] is a postnatal withdrawal syndrome that comprises a constellation of symptoms in newborns, including central nervous system irritability (eg, tremors, increased muscle tone, high-pitched crying and seizures), gastrointestinal dysfunction (eg, feeding difficulties), and temperature instability,” Jean Y. Ko, PhD, of the CDC’s National Center for Chronic Disease Prevention and Health Promotion, and colleagues wrote. “Although other substances have been implicated, NAS is most often attributed to in utero opioid exposure.”

To examine state trends in NAS, the researchers analyzed all-payer, hospital inpatient delivery discharges compiled in the State Inpatient Databases of the Healthcare Cost and Utilization Project during 1999 to 2013. The State Inpatient Databases include administration data from all hospital inpatient discharges in a given state, regardless of payer. Those data are then compiled and converted into a uniform format in the Healthcare Cost and Utilization Project, which is sponsored by the Agency for Healthcare Research and Quality.

The study focused on 28 states in which data for 1993 to 2013 were publically available through the Healthcare Cost and Utilization Project. Those states were Arizona, Arkansas, California, Colorado, Florida, Hawaii, Iowa, Kentucky, Maine, Maryland, Massachusetts, Michigan, Mississippi, Nebraska, Nevada, New Jersey, New Mexico, New York, North Carolina, Oregon, Rhode Island, South Carolina, South Dakota, Utah, Vermont, Washington, West Virginia and Wisconsin.

According to the researchers, the overall NAS incidence rate among the 28 states increased 300%, from 1.5 per 1,000 hospital births in 1999, to 6 per 1,000 in 2013. In addition, from 1999 to 2013, significant increases in NAS occurred in 25 of the 27 states with at least 3 years of data. Annual incidence rate changes ranged from 0.05 per 1,000 births in Hawaii, to 3.6 per 1,000 births in Vermont. In 2013, NAS prevalence ranged from 0.7 per 1,000 hospital births, in Hawaii, to 33.4 cases per 1,000 births, in West Virginia.

“Prevention efforts, such as promotion of effective use of prescription drug monitoring programs, are needed to reduce inappropriate prescribing and dispensing of opioids,” Ko and colleagues wrote. “Clinicians should follow recommended guidelines on appropriate prescribing of opioid medications, and provide screening and treatment for opioid use disorder among pregnant and nonpregnant women of reproductive age.” – by Jason Laday

Disclosure: The researchers report no relevant financial disclosures.