Atwell Karina A, Weiss Harold B, Gibson Crystal, Miller Richard, Corden Timothy E
WMJ. 2016 Dec;115(6):287-94.
Increasing rates of neonatal abstinence syndrome (NAS), most commonly linked to maternal opioid use, are a growing concern within clinical and public health domains.
The study aims to describe the statewide burden of NAS and maternal substance use, focusing on opioids in Wisconsin from 2009 to 2014.
Trends in NAS and maternal substance use diagnosis rates were calculated using Wisconsin’s Hospital Discharge Data. Demographic and payer characteristics, health service utilization, and clinical outcomes were compared for newborns with and without NAS. Demographic and payer characteristics were compared between women with and without substance use identified at time of delivery.
Rates of NAS and maternal substance use, most notably opioid use, increased significantly between 2009 and 2014. The majority of newborns diagnosed with NAS, and women identified with substance use, were non-Hispanic, white, and Medicaid-insured. Disproportionate rates of NAS and maternal opioid use were observed in American Indian/Alaska Native and Medicaid populations compared to white and privately insured groups, respectively. Women age 20-29 years had the highest rates of opioid use compared to the reference group (10-19 years). Odds of adverse clinical outcomes and levels of health service utilization were significantly higher for newborns with NAS.
Similar to trends nationally, our findings show an increase in maternal opioid use and NAS rates in Wisconsin over time, with disproportionate effects in certain demographic groups. These findings support the need for targeted interventions in clinical and public health settings aimed at prevention and burden reduction of NAS and maternal substance use in Wisconsin.
新生儿戒断综合征（NAS）的发病率不断上升，这一情况最常与母亲使用阿片类药物有关，已成为临床和公共卫生领域日益关注的问题。
本研究旨在描述威斯康星州新生儿戒断综合征和母亲物质使用的负担情况，重点关注2009年至2014年期间该州的阿片类药物使用情况。
利用威斯康星州医院出院数据计算新生儿戒断综合征和母亲物质使用诊断率的趋势。对患有和未患有新生儿戒断综合征的新生儿的人口统计学和支付方特征、卫生服务利用情况及临床结局进行比较。对分娩时被确定有或没有物质使用情况的女性的人口统计学和支付方特征进行比较。
2009年至2014年期间，新生儿戒断综合征和母亲物质使用（尤其是阿片类药物使用）的发生率显著上升。大多数被诊断患有新生儿戒断综合征的新生儿以及被确定有物质使用情况的女性为非西班牙裔白人且参加了医疗补助计划。与白人群体和私人保险群体相比，美国印第安人/阿拉斯加原住民群体和医疗补助计划参保人群中，新生儿戒断综合征和母亲阿片类药物使用的发生率分别较高。与参照组（10 - 19岁）相比，20 - 29岁的女性阿片类药物使用率最高。患有新生儿戒断综合征的新生儿出现不良临床结局和卫生服务利用水平较高的几率显著更高。
与全国趋势相似，我们的研究结果表明，随着时间推移，威斯康星州母亲阿片类药物使用和新生儿戒断综合征发生率有所上升，且对某些人口群体产生了不均衡影响。这些研究结果支持在临床和公共卫生环境中采取有针对性的干预措施，以预防和减轻威斯康星州新生儿戒断综合征和母亲物质使用的负担。
