Division of Neonatology, Department of Pediatrics, University at Buffalo, Buffalo, New York.
Division of Neonatology, Department of Pediatrics, University of California at Davis, Sacramento, California.
Am J Perinatol. 2024 May;41(S 01):e654-e663. doi: 10.1055/a-1925-1659. Epub 2022 Aug 16.
Our objective was to evaluate the trend and to assess the impact of maternal region of residence in Western New York (WNY), on severe neonatal opioid withdrawal syndrome (NOWS).
Term infants' born at gestational age greater than or equal to 37 weeks with severe NOWS, defined as withdrawal resulting in the receipt of pharmacologic therapy from WNY admitted to our neonatal intensive care unit (NICU) from January 1, 2008 to December 31, 2016, were included. Severe NOWS admissions to our NICU from the following five regions were controlled with birth and insurance data: (1) Urban North, (2) Erie Coastal, (3) Niagara Frontier, (4) Southern Tier, and (5) Urban South.
"Urban South" residence was associated with an increased risk of severe NOWS (adjusted odds ratio = 1.8, 97.5% confidence interval: 1.1-2.9). The trend in admission for severe NOWS doubled between 2008 to 2010 and 2014 to 2016 ( = 0.01). More infants born to maternal nonprescribed opioid users were placed in foster care at discharge (36.5 vs. 1.9%, < 0.001).
In WNY, neonates born to mothers from the "Urban South" were twice at risk of being admitted for severe NOWS. One-third of infants with severe NOWS after nonprescribed opioid use were placed in foster care. Implementing targeted strategies at the community level may help improve outcomes in NOWS.
· Maternal region of residence is a risk factor for severe neonatal opioid withdrawal.. · Admissions for severe neonatal opioid withdrawal trended up from 2008 to 2010 to 2014 to 2016.. · One-third of the infants born to mothers on nonprescribed opioids were discharged to foster care..
本研究旨在评估西纽约（WNY）产妇居住地的趋势，并评估其对严重新生儿阿片戒断综合征（NOWS）的影响。
纳入了 2008 年 1 月 1 日至 2016 年 12 月 31 日在 WNY 出生、胎龄大于或等于 37 周、因接受药物治疗而患有严重 NOWS 的足月婴儿。通过分娩和保险数据对我院新生儿重症监护病房（NICU）收治的来自以下五个地区的严重 NOWS 住院患者进行控制：（1）城市北部，（2）伊利沿海，（3）尼亚加拉边境，（4）南蒂尔，（5）城市南部。
“城市南部”居民发生严重 NOWS 的风险增加（调整后的优势比=1.8，97.5%置信区间：1.1-2.9）。2008 年至 2010 年和 2014 年至 2016 年，严重 NOWS 入院人数增加了一倍（ = 0.01）。更多非处方阿片类药物使用者的婴儿在出院时被安置在寄养家庭（36.5%比 1.9%， < 0.001）。
在 WNY，来自“城市南部”的产妇所生婴儿患严重 NOWS 的风险是其他地区的两倍。三分之一使用非处方阿片类药物后出现严重 NOWS 的婴儿被安置在寄养家庭。在社区层面实施有针对性的策略可能有助于改善 NOWS 的结局。
·产妇居住地是严重新生儿阿片戒断的危险因素。·严重新生儿阿片戒断的入院人数从 2008 年至 2010 年呈上升趋势，至 2014 年至 2016 年达到高峰。·三分之一的母亲使用非处方阿片类药物后分娩的婴儿被送往寄养家庭。
