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Pediatrics. 2019 Aug;144(2). pii: e20183664. doi: 10.1542/peds.2018-3664. Epub 2019 Jul 12.

Neonatal Abstinence Syndrome and Associated Neonatal and Maternal Mortality and Morbidity.

Author information

1
Departments of Obstetrics and Gynecology and slisonkova@cfri.ca.
2
School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
3
Departments of Obstetrics and Gynecology and.
4
Pediatrics, University of British Columbia and the British Columbia Women's Hospital and Health Center, Vancouver, British Columbia, Canada.
5
Department of Statistics and Actuarial Sciences, Simon Fraser University, Burnaby, British Columbia, Canada.
6
Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada.
7
Northern Medical Program, University of British Columbia, Prince George, British Columbia, Canada; and.
8
Centre for Health Evaluation and Outcome Sciences, Providence Health Care, St Paul's Hospital, Vancouver, Canada.

Abstract

OBJECTIVES:

We examined demographic characteristics and birth outcomes of infants with neonatal abstinence syndrome (NAS) and their mothers in Canada.

METHODS:

This retrospective, population-based, descriptive cross-sectional study of mother-infant dyads included all singleton live births in Canada (excluding Quebec), from 2005-2006 to 2015-2016 (N = 2 881 789). Demographic characteristics, NAS, and neonatal and maternal morbidities were identified from delivery hospitalization data (including diagnostic codes). The main composite outcomes were maternal and neonatal mortality and/or severe morbidity, including death and potentially life-threatening conditions in the mother and the infant, respectively. Logistic regression yielded adjusted odds ratios (aORs) and 95% confidence intervals (CIs).

RESULTS:

The study included 10 027 mother-infant dyads with NAS. The incidence of NAS increased from 0.20% to 0.51%. Maternal mortality was 1.99 vs 0.31 per 10 000 women in the NAS group versus the comparison group (aOR = 6.53; 95% CI: 1.59 to 26.74), and maternal mortality and/or severe morbidity rates were 3.10% vs 1.35% (aOR = 2.21; 95% CI: 1.97 to 2.49). Neonatal mortality was 0.12% vs 0.19% (aOR = 0.28; 95% CI: 0.15 to 0.53), and neonatal mortality and/or severe morbidity rates were 6.36% vs 1.73% (aOR = 2.27; 95% CI: 2.06 to 2.50) among infants with NAS versus without NAS.

CONCLUSIONS:

NAS incidence increased notably in Canada between 2005-2006 and 2015-2016. Infants with NAS had elevated severe morbidity, and their mothers had elevated mortality and severe morbidity. These results highlight the importance of implementing integrated care services to support the mother-infant dyad during childbirth and in the postpartum period.

PMID:
31300529
DOI:
10.1542/peds.2018-3664

Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

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