Infants with Drug Withdrawal Syndrome More Likely to Be Readmitted

Infants born with neonatal abstinence syndrome (NAS) — an addiction to opioids due to exposure in the womb — are nearly two and a half times as likely to be readmitted to the hospital within the first month after discharge compared to healthy full-term infants, according to a new study by Vanderbilt University.

Drug withdrawal symptoms can occur shortly after delivery in infants whose mothers had been taking opioid pain relievers such as hydrocodone. Compared to other infants, those with drug withdrawal are more likely to experience respiratory complications, feeding difficulty, seizures, and low birth weight.

The research is part of an ongoing series of Vanderbilt studies that are investigating the far-reaching implications, short-term and long-term, of drug exposure and withdrawal in newborns. Previous findings have shown that rates of NAS have increased nearly fivefold in the past decade across the U.S. Still, little is known about infants with NAS after their initial hospitalization following birth.

In this latest study, the researchers wanted to find out whether infants with NAS are at an increased risk for hospital readmission within 30 days from discharge compared with uncomplicated term and late preterm newborns.

“The recent rise of neonatal abstinence syndrome led to efforts in many hospital systems to improve hospital care being delivered to infants with the syndrome. Our findings suggest that these improvements need to extend beyond the initial birth hospitalization to ensure a safe discharge home,” said lead investigator Stephen Patrick, M.D., MPH, MS, assistant professor of Pediatrics and Health Policy in the Division of Neonatology at Monroe Carell Jr. Children’s Hospital at Vanderbilt.

For the study, the researchers analyzed hospital discharge data for 2006-2009 from the New York State Inpatient Database (SID) and also looked at data for live births from the New York Department of Health. During that time, there were 700,613 uncomplicated term births and 51,748 late preterm births (born between 33 and 36 weeks gestation). Of those births, 1,643 infants were diagnosed with NAS.

The most common cause for readmission among infants with NAS was withdrawal, whereas the preterm newborns were most commonly readmitted for jaundice.

Patrick said future research and state-level policies should look for ways to lower the risk of hospital readmission for infants with NAS.

“As state and federal policymakers work towards strategies to improve outcomes for women with substance use disorder and their infants, it will be important to ensure that families are supported during the critical transition from hospital to home to limit the risk of hospital readmission. The findings of our study suggest that some families may benefit from additional post-discharge resources.”

The findings are published in the journal Hospital Pediatrics.

Source: Vanderbilt University Medical Center