Context Neonatal abstinence syndrome (NAS) is a postnatal drug withdrawal syndrome primarily caused by maternal opiate use. No national estimates are available for the incidence of maternal opiate use at the time of delivery or NAS. Objectives To determine the national incidence of NAS and antepartum maternal opiate use and to characterize trends in national health care expenditures associated with NAS between 2000 and 2009. Design, Setting, and Patients A retrospective, serial, cross-sectional analysis of a nationally representative sample of newborns with NAS. The Kids' Inpatient Database (KID) was used to identify newborns with NAS by International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code. The Nationwide Inpatient Sample (NIS) was used to identify mothers using diagnosis related groups for vaginal and cesarean deliveries. Clinical conditions were identified using ICD-9-CM diagnosis codes. NAS and maternal opiate use were described as an annual frequency per 1000 hospital births. Missing hospital charges ( Main Outcome Measures Incidence of NAS and maternal opiate use, and related hospital charges. Results The separate years (2000, 2003, 2006, and 2009) of national discharge data included 2920 to 9674 unweighted discharges with NAS and 987 to 4563 unweighted discharges for mothers diagnosed with antepartum opiate use, within data sets including 784 191 to 1.1 million discharges for children (KID) and 816 554 to 879 910 discharges for all ages of delivering mothers (NIS). Between 2000 and 2009, the incidence of NAS among newborns increased from 1.20 (95% CI, 1.04-1.37) to 3.39 (95% CI, 3.12-3.67) per 1000 hospital births per year (P for trend Conclusion Between 2000 and 2009, a substantial increase in the incidence of NAS and maternal opiate use in the United States was observed, as well as hospital charges related to NAS.
Some women continue to use opiates when they are pregnant, yet heroin readily crosses the placenta. Opiate-dependent women experience a six-fold increase in maternal obstetric complications and give birth to low-weight babies. The newborn may experience narcotic withdrawal (neonatal abstinence syndrome) and have development problems. There is also increased neonatal mortality and a 74-fold increase in the risk of sudden infant death syndrome. Maintenance treatment with methadone provides a stead...
In 1998, a live, attenuated tetravalent rotavirus vaccine (RotaShield; Wyeth) was recommended for routine use in infants but was then withdrawn in 1999 after concerns arose suggesting an excess risk of intussusception among infants in the weeks following receipt of vaccine.1,2 As a result, larger prelicensure trials with more than 60 000 infants were performed for a pentavalent rotavirus vaccine (RotaTeq; Merck) and a monovalent rotavirus vaccine (Rotarix; GlaxoSmithKline), neither of which was ...
Background Patients with sickle cell anemia (SCA) experience a broad range of psychiatric disorders, placing them at risk for more complicated and longer hospitalizations for vaso-occlusive crises (VOC). The current study examined the frequency of psychiatric disorders in SCA patients (ages birth to 20 years) admitted for VOC in a nationally representative sample and the association between psychiatric disorders and hospital length of stay (LOS). Procedure Patients with a primary diagnosis of SC...
OBJECTIVE: The objective was to describe the characteristics of pediatric discharges associated with long-term mechanical ventilation (LTMV) compared with those with complex chronic conditions (CCCs), and evaluate trends over time in health care utilization for the discharges associated with LTMV.
Objective The purpose of this study was to evaluate trends and prevalence of chronic prescription narcotic use during pregnancy and the subsequent neonatal outcomes. Study Design We conducted a retrospective cohort study of all deliveries at Mayo Clinic from 1998 through 2009; the data was obtained from prospectively maintained obstetrics and neonatal databases. Results Over the study time period, there were 26,314 deliveries; 167 women used prescription narcotics chronically during pregnancy. T...
Background Methadone, a full mu-opioid agonist, is the recommended treatment for opioid dependence during pregnancy. However, prenatal exposure to methadone is associated with a neonatal abstinence syndrome (NAS) characterized by central nervous system hyperirritability and autonomic nervous system dysfunction, which often requires medication and extended hospitalization. Buprenorphine, a partial mu-opioid agonist, is an alternative treatment for opioid dependence but has not been extensively st...
Background Neonatal abstinence syndrome (NAS) due to opiate withdrawal may result in disruption of the mother-infant relationship, sleep-wake abnormalities, feeding difficulties, weight loss and seizures. Treatments used to ameliorate symptoms and reduce morbidity include opiates, sedatives and non-pharmacological treatments. Objectives To assess the effectiveness and safety of using a sedative compared to a non-opiate control for NAS due to withdrawal from opiates, and to determine which type o...
Background:Pediatric observation units provide an alternative to traditional hospitalization. The extent to which observation units could replace inpatient care for asthmatic children is unknown.Objective:To describe brief inpatient (“high-turnover,” HTO) stays for US children hospitalized with a pr
Abstract null null Maternal opioid use during pregnancy is a rapidly growing public health crisis and is associated with a range of adverse developmental outcomes including externalizing behaviors among exposed children. Recent work has highlighted the role of indirect pathways from prenatal opioid exposure to behavioral outcomes through aspects of the caregiving environment, including parenting. This review highlights maternal sensitivity and related aspects of the caregiving environment that m...
Resumen Objetivos Determinar la prevalencia del abuso de drogas entre nuestras gestantes y las caracteristicas de sus embarazos, partos y recien nacidos. Metodos Estudio observacional retrospectivo de los neonatos nacidos entre el 1 de enero de 2009 y el 31 de diciembre de 2017 en nuestro centro, hijos de madres consumidoras, y comparacion con nuestro estudio de 2002-2008. Resultados El consumo de heroina esta disminuyendo, mientras que el de cannabis y metanfetamina estan aumentando. Observamos...
BACKGROUND AND OBJECTIVES null Neonatal opioid withdrawal syndrome (NOWS) is associated with long and costly birth hospitalization and increased readmission risk. Our objective was to examine readmissions in the first year of life for infants diagnosed with NOWS compared with infants without NOWS, adjusting for sociodemographic and clinical factors, and to describe use during readmissions in this population. null METHODS null Using data from the Pediatric Health Information System, we identified...
Last. Hossein Azizi(TMU: Tarbiat Modares University)H-Index: 18
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Rationale null An alarming number of neonates born with prenatal exposure to morphine has resulted from the opioid epidemic; however, the long-term effects of prenatal opioid exposure on offspring behavior remain relatively unknown. In this study, we evaluated whether prenatal exposure to the mu opioid receptor agonist, morphine, has enduring effects on cognitive functions in adult life. null Methods null On embryonic days 11-18 (E11-E18), female pregnant rats were injected subcutaneously with e...
The aim of this review is to highlight our knowledge of the various drugs of abuse that can prove potential teratogens affecting the brain and cognitive development in an individual exposed to maternal consumption of such agents. Among several drugs of abuse in women, we specifically highlighted the commonly used alcohol, nicotine, opioids, cannabis, cocaine and marijuana. These drugs can affect the fetal development and slow the cognitive maturation apart from physical disabilities. However, no...
Abstract null null Background null The U.S. is facing a substance use crisis. One consequence, resulting from overdose deaths, arrests, parental and prenatal substance use, is increased reliance on the foster care system. In response to concerns about prenatal substance use, some states adopted policies that treat prenatal substance use identified at birth as child abuse or neglect. null null null Objective null To investigate the effects of state-level policies treating prenatal substance use a...
Last. Allan De Jong(Alfred I. duPont Hospital for Children)H-Index: 1
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Abstract null null Improving health and well-being of mothers, infants, and children represents a national public health priority, with emphasis placed on understanding how environmental and social determinants (access to quality health care, education, employment, economic opportunities, social support, and resource availability) influence maternal health behaviors and infant-child well-being. Substance use during pregnancy is a predominant maternal-infant health risk; many affected mother-infa...
The opioid crisis has greatly affected not only adults but also children as well. As clinicians develop effective approaches to minimize pain and distress in children, the risks and benefits of opioids must be carefully considered. Children of parents with opioid use disorder are also at risk of living in unstable environments, performing poorly academically, engaging in future drug use, and having increased stress, which affects their development before entering adulthood. This statement focuse...
BACKGROUND AND OBJECTIVES null Hospital discharge records remain a common data source for tracking the opioid crisis among pregnant women and infants. The International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) transition from the International Classification of Diseases, Ninth Revision, Clinical Modification may have affected surveillance. Our aim was to evaluate this transition on rates of neonatal abstinence syndrome (NAS), maternal opioid use disorder (OUD)...