Opioids Responsible for Neonatal Abstinence Syndrome Increase

The incidence of neonatal abstinence syndrome (NAS) due to opioid use during pregnancy is increasing dramatically in the United States, according to a new study.

Researchers at Penn State College of Medicine (Hershey, PA, USA) conducted a retrospective, observational study to measure the inflation-adjusted health care provider costs and length of hospital stay for 27,943 patients with NAS, comparing them to data from 3,783,629 infants without NAS. The results showed that between 2003 and 2012, NAS admissions increased more than fourfold, resulting in a surge in annual costs from USD 61 million and 67,869 hospital days in 2003, to nearly USD 316 million and 291,168 hospital days in 2012.

The results also revealed that for an infant affected by NAS, the hospital stay was nearly 3.5 times as long (16.57 hospital days) compared with just 4.98 days for a non-NAS patient. The added costs were more than three times greater, at USD 16,893, compared with USD 5,610 for a non-affected infant. According to the researchers, increased public health initiatives are needed to target, educate, and provide resources for women of reproductive age to decrease in-utero drug exposure. The study was published on June 14, 2017, in Addiction.

“Opioid use during pregnancy comes at a cost to the baby, both in potential withdrawal symptoms as well as length of hospital admission. State policies vary in their treatment of pregnant women who have a substance abuse problem,” concluded lead author Tammy Corr, DO, of the division of newborn medicine, and colleagues. “Rather than treating substance abuse as a crime, which may discourage expectant mothers from seeking help, we need drug treatment programs that are specifically targeted to pregnant women.”

NAS is a constellation of symptoms that occur in newborn infants exposed to addictive illegal or prescription drugs in utero. Infants affected by NAS typically show a number of neurological symptoms and behaviors, such as tremors and seizures, as well as poor feeding and gastrointestinal dysfunction. Standard management of NAS involves administration of opioids for opioid withdrawal, with additional medications for stubborn cases or instances of multi-drug exposure. This drug administration has been performed traditionally in the hospital setting, consuming valuable and finite hospital resources.

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Penn State College of Medicine