New evidence from a team of American researchers points to a recent, steep rise in the number of U.S. women who give birth to children with neonatal abstinence syndrome, an opioid withdrawal-related condition.
Pregnant women who consume opioid drugs or medications inevitably introduce those substances into the bloodstreams of their developing children. In some cases, this situation leads to the onset of neonatal abstinence syndrome in affected newborns. In a study published in April 2015 in the Journal of Perinatology, researchers from several U.S. institutions examined recent rates of this condition in the U.S. population. These researchers concluded that the number of babies born with neonatal abstinence syndrome jumped sharply over a short span of time in the transition from the 2000s to the 2010s.
Opioid Use Trends
Figures compiled by the federal Centers for Disease Control and Prevention show a steep rise in the number of opioid prescriptions written by American doctors between the early 1990s and the beginning of the 2010s. Accompanying this rise was an increase in the number of people seeking treatment for opioid abuse or addiction, the number of people requiring emergency treatment for opioid-related health problems and the number of people dying from opioid overdoses. The upward trend of opioid prescribing has reversed somewhat in the last several years. However, at the same time, people who misuse opioid medications have displayed a rising tendency to transition into heroin consumption in general and injection heroin use in particular.
Neonatal Abstinence Syndrome
Pregnant women and their developing children have bloodstreams that meet inside the placenta. While the placenta filters out some substances and prevents them from passing into a fetus, it does not screen out everything capable of causing harm. Unfortunately, opioid drugs and medications (as well as a broad range of other addictive substances) can pass through the placental barrier and enter a developing child’s bloodstream. Even more than adults and children, fetuses are susceptible to the addicting, brain-altering effects of opioid substances. Neonatal abstinence syndrome (NAS) arises when a newborn child exposed to opioids in the womb develops opioid withdrawal symptoms after losing access to his or her mother’s bloodstream. Possible indications of the condition include tremors, seizures, skin that looks blotchy or mottled, fever, diarrhea, unrelieved crying, poor feeding ability, a reduced rate of weight gain and vomiting.
Neonatal abstinence syndrome is usually viewed as a possible problem in the context of the use of illicit/illegal street opioids like heroin. However, according to the results of a study published in 2015 in the journal Pediatrics, newborns can also develop the condition when their mothers consume opioid medications during pregnancy. The authors of this study specifically linked the presence of prescription opioid-related NAS to increased risks for unusually low birth weight.
Number of Affected Children
In the study, researchers from Vanderbilt University, the Vanderbilt Center for Health Services Research and the University of Michigan used information from two sources—the Nationwide Inpatient Sample and the Kids’ Inpatient Database—to examine trends in the national rate of neonatal abstinence syndrome. The years under consideration for the project were 2009 to 2012. After analyzing the sources, the researchers concluded that 3.4 out of every 1,000 children born in U.S. hospitals in 2009 had diagnosable symptoms of NAS. By 2012, the rate of affected children had risen to 5.8 out of every 1,000 newborns. This figure reflects a short-time rise in NAS cases of 71 percent. In 2012, a baby with the syndrome was born approximately every 25 minutes.
A grouping of states identified by the researchers as the East South Central Division (including Alabama, Tennessee, Mississippi and Kentucky) had the nation’s peak rate of NAS births in 2012 at 16.2 cases per every 1,000 children born in a hospital. Another grouping of states identified as the West South Central Division (including Louisiana, Texas, Arkansas and Oklahoma) had the nation’s lowest 2012 rate at just 2.6 cases per every 1,000 children born in a hospital.
The study’s authors estimate that the cost of treating newborns with neonatal abstinence syndrome in 2012 reached $1.5 billion (more than double the $732 million expenditure in 2009). Given the personal, social and financial impact of the condition, they urge public health officials to redouble their efforts to reach at-risk women, especially women who misuse opioid medications.