TY - JOUR
T1 - Neonatal Abstinence Syndrome in West Virginia Substate Regions, 2007-2013
AU - Stabler, Meagan E.
AU - Long, D. Leann
AU - Chertok, Ilana R.A.
AU - Giacobbi, Peter R.
AU - Pilkerton, Courtney
AU - Lander, Laura R.
N1 - Funding Information:
This work was supported by the National Institute of General Medical Sciences, NIH grant U54GM104942 (DLL).
Publisher Copyright:
© 2016 National Rural Health Association
PY - 2017/12/1
Y1 - 2017/12/1
N2 - Purpose: The opioid epidemic is a public health threat with consequences affecting newborns. Neonatal Abstinence Syndrome (NAS) is a constellation of withdrawal symptoms resulting primarily from in utero opioid exposure. The purpose of this study was to examine NAS and drug-specific trends in West Virginia (WV), where rurality-related issues are largely present. Methods: The 2007-2013 WV Health Care Authority, Uniform Billing Data were analyzed for 119,605 newborn admissions with 1,974 NAS diagnoses. NAS (ICD9-CM 779.5) and exposure diagnostic codes for opioids, hallucinogens, and cocaine were utilized as incidence rate (IR) per 1,000 live births. Findings: Between 2007 and 2013, NAS IR significantly increased from 7.74 to 31.56 per 1,000 live births per year (Z: -19.10, P <.0001). During this time period, opioid exposure increased (Z: -9.56, P <.0001), while cocaine exposure decreased (Z: 3.62, P =.0003). In 2013, the southeastern region of the state had the highest NAS IR of 48.76 per 1,000 live births. NAS infants were more likely to experience other clinical conditions, longer hospital stay, and be insured by Medicaid. Conclusions: Statewide NAS IR increased 4-fold over the study period, with rates over 3 times the national annual averages. This alarming trend is deleterious for the health of WV mother-child dyads and it strains the state's health care system. Therefore, WV has a unique need for prenatal public health drug treatment and prevention resources, specifically targeting the southeastern region. Further examination of maternal drug-specific trends and general underutilization of neonatal exposure ICD-9-CM codes is indicated.
AB - Purpose: The opioid epidemic is a public health threat with consequences affecting newborns. Neonatal Abstinence Syndrome (NAS) is a constellation of withdrawal symptoms resulting primarily from in utero opioid exposure. The purpose of this study was to examine NAS and drug-specific trends in West Virginia (WV), where rurality-related issues are largely present. Methods: The 2007-2013 WV Health Care Authority, Uniform Billing Data were analyzed for 119,605 newborn admissions with 1,974 NAS diagnoses. NAS (ICD9-CM 779.5) and exposure diagnostic codes for opioids, hallucinogens, and cocaine were utilized as incidence rate (IR) per 1,000 live births. Findings: Between 2007 and 2013, NAS IR significantly increased from 7.74 to 31.56 per 1,000 live births per year (Z: -19.10, P <.0001). During this time period, opioid exposure increased (Z: -9.56, P <.0001), while cocaine exposure decreased (Z: 3.62, P =.0003). In 2013, the southeastern region of the state had the highest NAS IR of 48.76 per 1,000 live births. NAS infants were more likely to experience other clinical conditions, longer hospital stay, and be insured by Medicaid. Conclusions: Statewide NAS IR increased 4-fold over the study period, with rates over 3 times the national annual averages. This alarming trend is deleterious for the health of WV mother-child dyads and it strains the state's health care system. Therefore, WV has a unique need for prenatal public health drug treatment and prevention resources, specifically targeting the southeastern region. Further examination of maternal drug-specific trends and general underutilization of neonatal exposure ICD-9-CM codes is indicated.
KW - geographic variation
KW - neonatal abstinence syndrome
KW - opioid use
KW - prenatal drug abuse
KW - rural health
UR - http://www.scopus.com/inward/record.url?scp=84959111356&partnerID=8YFLogxK
U2 - 10.1111/jrh.12174
DO - 10.1111/jrh.12174
M3 - Article
C2 - 26879950
AN - SCOPUS:84959111356
SN - 0890-765X
VL - 33
SP - 92
EP - 101
JO - Journal of Rural Health
JF - Journal of Rural Health
IS - 1
ER -