Association between Neonatal Abstinence Syndrome and Congenital Anomalies in the United States

Parth Bhatt; Cecilia Ampem-Darko; Grace Annan Cudjoe; Narendrasinh Parmar; Igbagbosanmi Oredein; Adwoa O. Asiama; Jenil Patel; Sahithi Pemmasani; Vijay Gandhi Linga; Keyur Donda; Harshit Doshi; Fredrick Dapaah-Siakwan

doi:10.1055/s-0042-1759864

American Journal of Perinatology, Table of Contents

Am J Perinatol 2024; 41(S 01): e1023-e1029
DOI: 10.1055/s-0042-1759864

Original Article

Association between Neonatal Abstinence Syndrome and Congenital Anomalies in the United States

Parth Bhatt

¹Department of Pediatrics, United Hospital Center, Bridgeport, West Virginia

,

Cecilia Ampem-Darko

²Department of Pediatrics, Tema General Hospital, Tema, Ghana

,

Grace Annan Cudjoe

³Department of Pediatrics, University of Ghana School of Medicine and Dentistry, Accra, Ghana

,

Narendrasinh Parmar

⁴Section of Emergency Medicine, East Tennessee Children's Hospital, Knoxville, Tennessee

,

Igbagbosanmi Oredein

⁵Pediatric Residency Program, Hurley Medical Center, Flint, Michigan

,

Adwoa O. Asiama

⁶Department of Medicine, Pantang Hospital, Accra, Greater Accra, Ghana

,

Jenil Patel

⁷Center for Pediatric and Population Health, School of Public Health, University of Texas Health Science Center at Houston (UT Health), Texas

,

Sahithi Pemmasani

⁸Pediatric Residency Program, Icahn School of Medicine at Mount Sinai, Elmhurst Hospital Center, New York, New York

,

Vijay Gandhi Linga

⁹Department of Pediatrics, San Juan Regional Medical Center, Farmington, New Mexico

,

Keyur Donda

¹⁰Division of Neonatology, Department of Pediatrics, University of South Florida, Tampa, Florida

,

Harshit Doshi

¹¹Golisano Children's Hospital of Southwest Florida, Fort Myers, Florida

,

Fredrick Dapaah-Siakwan

¹²Department of Medicine, Valley Children's Hospital, Madera, California

› Author Affiliations

Abstract

Objective Studies exploring the relationship between neonatal abstinence syndrome (NAS) and congenital anomalies (CA) in the United States are limited given the small sample size or data prior to the opioid epidemic. We aimed to determine if there is an association between NAS and CA in a nationally representative cohort of newborn hospitalization in the United States.

Study Design This was a cross-sectional analysis of NAS-related hospitalizations within the 2016 Kids Inpatient Database. International Classification of Diseases (ICD-10-CM) diagnostic codes were used to identify NAS hospitalizations and those with and without CA. The primary outcome was the odds of CAs in NAS hospitalizations. Multivariate survey logistic regression was used to analyze the relationship between NAS and CA.

Results Among 3.7 million newborn hospitalizations, 25,394 had NAS (6.7 per 1,000). The prevalence of any CA was higher in those with NAS when compared with non-NAS hospitalizations (10.3 vs. 4.9%; odds ratio = 2.27; 95% confidence interval [CI]: 2.13–2.43). Adjusted analysis showed similar results (adjusted odds ratio: = 1.83, CI: 1.71–1.95). NAS hospitalizations with CA had a higher mortality rate (0.6 vs 0.04%, p < 0.0001) and higher resource use.

Conclusion This nationwide study shows that NAS may be associated with increased odds of CAs, suggesting that NAS may be a risk factor for increased morbidity in the newborn period.

Key points

1 in 10 newborns with NAS had at least one congenital anomaly.
NAS hospitalization with congenital anomalies had higher resource use and mortality.
Pediatricians caring for newborns with NAS should have a high index of suspicion for birth defects.

Keywords

neonatal abstinence syndrome - congenital anomalies - Kids Inpatient Database - prevalence

Full Text

References

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Supplementary Material

Supplementary Material