Neonatal abstinence syndrome (NAS), a drug withdrawal syndrome in infants following birth, has historically been associated with illicit drug use such as heroin among pregnant women. But a study by a team at Vanderbilt University Medical Center shows that pregnant women are commonly being prescribed opioids — narcotic pain relievers such as hydrocodone — which results in an increased likelihood of NAS. In addition, the study found that opioid type and duration of exposure combined with tobacco use or selective serotonin reuptake inhibitor use (for treating depression and anxiety) augmented risks for NAS.
The study, “Prescription Opioid Epidemic and Infant Outcomes,” looked at three years of data from TennCare, Tennessee’s Medicaid program, and assessed records for 112,029 pregnant mothers. An estimated 28 percent of the women, or 31,354, were prescribed and filled at least one opioid pain reliever. Of the babies with NAS, 65 percent had mothers that legally filled prescriptions for opioid pain relievers.
Results were published this week in the journal Pediatrics.
“We found that babies exposed to opioids pain relievers were more likely to be born preterm, have complicated births, low birth weight and have complications such as meconium aspiration syndrome (a sign of infant distress at birth) and respiratory distress,” lead author Stephen Patrick, M.D., MPH, assistant professor of Pediatrics and Health Policy in the Division of Neonatology with the Monroe Carell Jr. Children’s Hospital at Vanderbilt, said in a news release.
The study shows that compared to women with no opioid exposure, the pregnant women who took opioid pain relievers were more likely to be white, have anxiety or depression, suffer from headache or migraine and have musculoskeletal disease. A majority of the women prescribed opioids, 96 percent, were prescribed short-acting medications, while 2 percent received maintenance doses and less than 1 percent received long-acting opioids.
“Historically, drug withdrawal for newborns has been described among illicit drug use such as heroin or women treated for previous opioid abuse, but this is really one of the first studies to look at legal prescriptions for pregnant women. And it draws attention to what is going on in our nation,” Patrick concluded.