Site-Level Variation in the Characteristics and Care of Infants with Neonatal Opioid Withdrawal

Author(s): Leslie Young, Zhuopei Hu, Robert Annett, et al.

What was done?

The medical records of babies born between July 1, 2016 and June 30, 2017 and their mothers were reviewed at 30 U.S. hospitals. From these records, 1377 babies were selected for the study.

For the babies, we looked at how many were given medicines for their NOWS symptoms and what they ate. We also looked at how long they were in the hospital, and who they went home with. For the mothers, we looked at what types of care they had during their pregnancy.

What was found?

The hospitals in this study varied in how they took care of pregnant women with opioid use and their babies.

In the babies:

• 6% to 100% received medicine for NOWS symptoms,
• 22% to 83% were fed breast milk,
• length of hospital stay was 2 to 28 days, and
• 33% to 91% went home with their parents.

In the mothers:

• 6% to 100% were given medicine for their opioid use disorder,
• 31% to 100% received adequate medical care during their pregnancy, and
• 2% to 75% received prenatal counseling.

What do the results mean?

This study suggests that the care for pregnant women who use opioids and their babies differs widely in the U.S. This means that some mothers and babies may not be getting the best care.

More research into the care we provide will help doctors find a standardized way to care for babies with NOWS. Standardized care will help all babies with NOWS get the best care possible.

Why was this study conducted?

Babies exposed to opioids in the womb may show signs of withdrawal after birth. This is called neonatal opioid withdrawal syndrome (NOWS). Babies with NOWS may tremble, have increased crying, or be more difficult to calm. They also may not sleep or eat well.

In the U.S., there is not a standard way to care for babies with NOWS after they are born. That means U.S. doctors may be treating babies with NOWS in different ways. This study looked at the variation in the care provided to babies with NOWS in the U.S.

Appreciation:

We deeply appreciate the doctors, nurses, and hospitals that participated in the study and helped identify and extract information from the required medical records. Their enthusiastic collaboration made this study possible. The authors thank the Environmental Influences on Child Health Outcomes Program, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the National Center for Advancing Translational Sciences, and the National Institutes of Health for supporting this research.

Access the full journal article, titled "Site-Level Variation in the Characteristics and Care of Infants With Neonatal Opioid Withdrawal," published in Pediatrics.

Published January 2021

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.