A rise in the number of pregnant women using opiates has led to a nearly threefold increase in the rate of infants born with symptoms of drug withdrawal, according to a study published online in the Journal of the American Medical Association. On average, researchers say a drug addicted baby is born every hour in the United States.
A research team at the University of Michigan Health System studied data from 2000 to 2009 and determined the rate of mothers using or dependent on opiates increased from 1.19 to 5.63 per 1,000 hospital births per year. During the same period, the rate of newborns diagnosed with symptoms of drug withdrawal increased from 1.20 to 3.39 per 1,000 hospital births.
The study included pregnant women who used prescribed or illegal opiates, including Vicodin, OxyContin and heroin. It is the first national study of the problem.
“Although our study was not able to distinguish the exact opiate used during pregnancy, we do know that the overall use of this class of drugs grew by 5-fold over the last decade and this appears to correspond with much higher rates of withdrawal in their infants,” says Stephen W. Patrick, MD, lead author of the study and a fellow in the University of Michigan’s Division of Neonatal-Perinatal Medicine.
Neonatal abstinence syndrome, or NAS, is characterized by tremors, seizures, intolerance to feeding, irritability, heightened muscle tone, and respiratory distress in newborns. NAS symptoms of withdrawal were noted in 60 to 80 percent of newborns exposed to methadone or heroin. Illicit drug use during pregnancy also significantly increases the risk of infant mortality and low birth weight (less than 5.5 pounds).
“You can often stand in the hallway and know which babies are experiencing withdrawal. They are irritable, their cries are different, and they appear uncomfortable,” Patrick says.
A recent national study found that 16.2% of pregnant teens and 7.4% of pregnant women aged 18 to 25 years use illicit drugs.
“Compared with all other hospital births, newborns with NAS were significantly more likely to have respiratory diagnoses (31%), to have low birth weight (19%), have feeding difficulties (18%), and have seizures (2%). Newborns with NAS were also more likely to be covered by Medicaid (78%) and reside in zip codes within the lowest income (36%),” the authors wrote.
Hospital charges and the length of stay in hospitals were also greater for newborns diagnosed with NAS. A 35% increase was noted in average hospital charges, from $39,400 to $53,000. Total hospital charges for NAS increased from $190 million in 2000 to $720 million in 2009.
“Newborns with NAS experience longer, often medically complex and costly initial hospitalizations. The increasing incidence of NAS and its related health care expenditures call for increased public health measures to reduce antenatal exposure to opiates across the United States,” the authors concluded.
The study was presented at the annual meeting of the Pediatric Academic Societies. A grant from the Robert Wood Johnson Foundation Clinical Scholars Program supported the study.