Opiate Use During Pregnancy, Infant Withdrawal on the Rise

Eileen Oldfield, Associate Editor
Published Online: Monday, May 7, 2012
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A study suggests that opiate drug use during pregnancy has increased so much that 1 infant was born with withdrawal symptoms each hour in 2009.

The portion of infants born with opiate withdrawal symptoms nearly tripled between 2000 and 2009, and the portion of pregnant women using opiates increased almost fivefold over the same period, according to a study published online on April 30, 2012, in the Journal of the American Medical Association.
 
The study’s authors, who analyzed pediatric discharge and maternal inpatient data, found that instances of newborns who undergo withdrawal treatment increased from 1.20 to 3.39 out of 1000 births. The authors estimate that, at this rate, approximately 1 infant was born exhibiting withdrawal symptoms per hour in 2009.
 
Opiate use among expecting mothers increased from 1.19 to 5.63 instances per 1000 births over the same period. The disparity between the rate of maternal opiate use and newborns who require withdrawal treatment suggests that some opiate-exposed newborns do not exhibit withdrawal signs, the researchers noted.

The authors of the study also investigated the costs involved with newborns undergoing opiate withdrawal treatment and found that they require longer, more expensive initial hospital stays that tend to include more complex services. The average charge per newborn undergoing withdrawal treatment jumped as well, increasing from $39,400 in 2000 to $53,400 in 2009, although the average length of stay was unchanged. The charges, which are inflation-adjusted, reflect the facility fees reported for each birth, but do not include professional fees.
 
Total nationwide hospital charges for births in which newborns had to undergo opiate withdrawal treatment increased from $190 million nationwide in 2000 to $720 million in 2009, according to the study. State Medicaid programs pay for many of the services and stays, with about 78.1% of newborn withdrawal charges and 60% of the mothers’ expenses being billed to Medicaid in 2009.
 
An accompanying editorial suggests that charges related to withdrawal treatment for newborns have the potential to strain the Medicaid program’s limited funds. The editorial also notes that reducing funding for addiction programs for mothers and care for newborns undergoing withdrawal treatment could have serious repercussions, as many children exposed to opiates in utero require special services for behavioral or developmental disorders later in life.

To read the study, click here. To read the accompanying editorial, click here. (Registration may be required for access to full text.)

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