Clinical trials specialist senior, Duke University Medical Center, Durham, North Carolina.
Clinical research nurse coordinator, Novant Health, Inc, Charlotte, North Carolina.
N C Med J. 2022 Mar-Apr;83(2):142-146. doi: 10.18043/ncm.83.2.142.
Neonatal abstinence syndrome (NAS) is a complex disorder characterized by withdrawal symptoms secondary to exposure to drugs capable of producing physical dependence. The objective of this study was to determine the incidence of NAS, as well as infant and maternal characteristics associated with NAS in North Carolina (NC). This retrospective, cross-sectional, observational study used the State Inpatient Database (SID) to compare the incidence rates of NAS for NC for the year 2016 to historical data (years 2000 to 2013). A multivariable logistic regression model including available covariates of interest was constructed. Overall NAS incidence rate (IR) for NC was found to be 9.7 per 1,000 live births, a 32.3-fold increase since 2000 (IR=0.3 in 2000). The multivariable logistic regression model suggested race group (both black [OR 0.11; 95% CI: 0.08, 0.16] and 'other' [OR 0.43; 95% CI: 0.31, 0.61] vs white), ethnicity [OR 0.43; 95% CI: 0.31, 0.61], insurance group (both 'other/self-pay' [OR 0.35; 95% CI: 0.24, 0.52] and 'private insurance' [OR 0.07; 95% CI: 0.05, 0.10] vs Medicaid/Medicare), region (Piedmont [OR 0.62; 95% CI: 0.50, 0.79] vs Mountain), income quartile (both 4th [OR 0.45; 95% CI: 0.26, 0.79] and 3rd [OR 0.70; 95% CI: 0.50, 0.96] vs 1st), county population size (50k-249k [OR 0.54; 95% CI: 0.34, 0.86] vs ≥1 million), birth weight [OR 0.87; 95% CI: 0.78, 0.98], and length of stay [OR 1.23; 95% CI: 1.20, 1.26] as potentially important predictors of NAS. Only hospitals providing data to the SID for 2016 were included and ICD-9 codes, in use at the time of data collection, were used. The incidence of NAS has increased in NC in 2016 compared to prior years spanning back to 2000. Specific infant and maternal characteristics including race, ethnicity, payer type, geographic region, county population, parental income status, birth weight, and length appear to be associated with an infant bearing the diagnosis of NAS.
新生儿戒断综合征（NAS）是一种复杂的疾病，其特征是因暴露于能够产生身体依赖性的药物而出现戒断症状。本研究旨在确定北卡罗来纳州（NC）NAS 的发病率，以及与 NAS 相关的婴儿和产妇特征。这项回顾性、横断面、观察性研究使用州住院患者数据库（SID）比较了 2016 年 NC 的 NAS 发病率与历史数据（2000 年至 2013 年）。构建了一个包含感兴趣的可用协变量的多变量逻辑回归模型。发现 NC 的总体 NAS 发病率（IR）为每 1000 例活产儿 9.7 例，自 2000 年以来增加了 32.3 倍（2000 年 IR 为 0.3）。多变量逻辑回归模型表明种族群体（黑人 [OR 0.11；95%CI：0.08，0.16] 和“其他” [OR 0.43；95%CI：0.31，0.61] 与白人）、族裔 [OR 0.43；95%CI：0.31，0.61]、保险类型（两者均为“其他/自付” [OR 0.35；95%CI：0.24，0.52] 和“私人保险” [OR 0.07；95%CI：0.05，0.10] 与医疗补助/医疗保险）、地区（皮埃蒙特 [OR 0.62；95%CI：0.50，0.79] 与山区）、收入四分位数（第四分位数 [OR 0.45；95%CI：0.26，0.79] 和第三分位数 [OR 0.70；95%CI：0.50，0.96] 与第一分位数）、县人口规模（50k-249k [OR 0.54；95%CI：0.34，0.86] 与≥100 万）、出生体重 [OR 0.87；95%CI：0.78，0.98] 和住院时间 [OR 1.23；95%CI：1.20，1.26] 可能是 NAS 的重要预测因素。仅纳入了 2016 年向 SID 提供数据的医院，并且使用了数据收集时使用的 ICD-9 代码。与 2000 年以前的年份相比，2016 年 NC 的 NAS 发病率有所增加。特定的婴儿和产妇特征，包括种族、族裔、支付类型、地理位置、县人口、父母收入状况、出生体重和住院时间，似乎与患有 NAS 的婴儿有关。
