Office of the Assistant Secretary for Planning & Evaluation, U.S. Department of Health and Human Services, 200 Independence Ave SW, Washington, DC, 20543, USA.
Mathematica, 1100 First Street, NE, 12th Floor, Washington, DC, 20002-4221, USA.
Matern Child Health J. 2023 Dec;27(Suppl 1):14-22. doi: 10.1007/s10995-023-03670-z. Epub 2023 May 23.
Estimating Neonatal Abstinence Syndrome (NAS) and prenatal substance exposure rates in Medicaid can help target program efforts to improve access to services.
The data for this study was extracted from the 2016-2020 Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files (TAF) Research Identifiable Files (RIF) and included infants born between January 1, 2016 and December 31, 2020 with a either a NAS diagnosis or prenatal substance exposure.
Between 2016 and 2020, the estimated national rate of NAS experienced a 18% decline, while the estimated national rate of prenatal substance exposure experienced a 3.6% increase. At the state level in 2020, the NAS rate ranged from 3.2 per 1000 births (Hawaii) to 68.0 per 1000 births (West Virginia). Between 2016 and 2020, 28 states experienced a decline in NAS births and 20 states had an increase in NAS rates. In 2020, the lowest prenatal substance exposure rate was observed in New Jersey (9.9 per 1000 births) and the highest in West Virginia (88.1 per 1000 births). Between 2016 and 2020, 38 states experienced an increase in the rate of prenatal substance exposure and 10 states experienced a decline.
Estimated rate of NAS has declined nationally, but rate of prenatal substance exposure has increased, with considerable state-level variation. The reported increase in prenatal substance exposure in the majority of US states (38) suggest that substances other than opioids are influencing this trend. Medicaid-led initiatives can be used to identify women with substance use and connect them to services.
在医疗补助计划中估计新生儿戒断综合征（NAS）和产前物质暴露率有助于将项目工作重点放在改善服务获取上。
本研究的数据来自 2016-2020 年转化医疗补助统计信息系统（T-MSIS）分析文件（TAF）研究可识别文件（RIF），包括 2016 年 1 月 1 日至 2020 年 12 月 31 日期间出生的患有 NAS 诊断或产前物质暴露的婴儿。
在 2016 年至 2020 年期间，NAS 的全国估计发生率下降了 18%，而产前物质暴露的全国估计发生率则上升了 3.6%。在 2020 年各州水平上，NAS 发生率范围从每千例出生 3.2 例（夏威夷）到每千例出生 68.0 例（西弗吉尼亚州）。在 2016 年至 2020 年期间，有 28 个州的 NAS 出生人数下降，20 个州的 NAS 率上升。2020 年，新泽西州（每千例出生 9.9 例）的产前物质暴露率最低，西弗吉尼亚州（每千例出生 88.1 例）最高。在 2016 年至 2020 年期间，有 38 个州的产前物质暴露率增加，有 10 个州的率下降。
NAS 的全国估计发生率下降，但产前物质暴露率增加，各州之间存在较大差异。美国大多数州（38 个）报告产前物质暴露增加表明，除阿片类药物外，其他物质也影响了这一趋势。医疗补助主导的倡议可用于识别有物质使用问题的妇女并为她们提供服务。
