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Neonatal abstinence syndrome rates soar from 2010-’17

April 1, 2021

Most states saw rates of neonatal abstinence syndrome (NAS) increase significantly from 2010-’2017, with rates rising 100% or more in 24 states, a recent study showed.

Pregnant women and infants are among those affected by the opioid crisis. Previous studies have shown rising rates of NAS and maternal opioid use disorder (MOD) since 2000.

Researchers sought to update estimated rates of NAS and MOD, examine variations among states and look at hospital length of stay and costs. To do so, they analyzed data from the Healthcare Cost and Utilization Project’s National Inpatient Sample and data from 47 states and the District of Columbia.

Results showed the estimated rate of NAS was 82% higher in 2017 than in 2010 (7.3 vs. 4 per 1,000 births). Significant increases were seen in all 42 states with data available in both years except Nebraska and Vermont.

NAS rates in 2017 varied widely among states. The rate was highest in West Virginia (53.5 per 1,000 birth hospitalizations) followed by Maine (31.4), Vermont (29.4), Delaware (24.2) and Kentucky (23.9). Nebraska had the lowest rate at 1.3 per 1,000.

The authors noted that variations among states could be due to differences in coding/surveillance definitions, treatment efforts among pregnant women and criminal penalties for substance use in pregnancy.

Data from 2017 also showed neonates with NAS were significantly more likely than other infants to be non-Hispanic White (77.5% vs. 52.2%), covered by Medicaid (84% vs. 46.3%), live in a ZIP code in the lowest quartile of median income (38.1% vs. 28.1%) and live in a nonmetropolitan county (22.1% vs. 13.4%).

Furthermore, infants with NAS had longer median lengths of stay (10.8 vs. 1.6 days) and higher estimated mean hospital costs ($18,800 vs. $4,200) than other infants.

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