Neonatal Abstinence Syndrome and Drug Use Among Pregnant Women in Ohio 2004-2011

ARTICLE REVIEW

Quick Facts
Between 2004-2011, there were over 5,000

hospitalizations for Neonatal Abstinence Syndrome

Cost of $70 million in 2011 alone

Rate of NAS grew from 14 to 88 per 10,000 between

these years Hospitalizations of mothers due to drug use while pregnant doubled from 2004-2o11

Drug trends

Marijuana>Opioids>Cocaine

Average Costs

Length of Stay

NAS vs. Noxious Substances

The numbers displayed above only pertained to NAS

infants

Does not account for infants exposed to noxious substances via breast milk

From 2004-2011 there was a 540% increase in rates

of hospitalizations due to exposure to noxious substances

Most common: opiates Runner-up: cocaine

Drug Dependence in Mothers

Drug Use by Trimester

The toll NAS takes on babies

Neonatal Abstinence Syndrome

PAMPHLET TO HAND OUT AT HOME VISITS AND AT THE CLINIC

What Is It?
Neonatal Abstinence Syndrome is a condition

that occurs in infants whose mothers used addictive drugs during pregnancy.

The misuse of prescription or illegal drugs can

be extremely harmful to a developing child

It is thought that 4.1 million child-bearing woman abuse drugs.

About 3% of these woman continue drug usage throughout their pregnancies!

Who Does It Affect

What Happens
A child with Neonatal

Abstinence Syndrome is born addicted to the drug that the mother was using during pregnancy. The substance passes through the placenta to the baby during pregnancy.

The placenta connects

the baby to the mothers womb. The baby becomes addicted along with the mother. Because the baby is so addicted, withdrawal symptoms may occur.

What Can Be Used?

Commonly Misused All types of drug usage

Drugs Amphetamines Barbiturates Benzodiazepines Cocaine Marijuana Opiate/Narcotics such as Heroin, methadone, codeine.

can lead to Neonatal Abstinence Syndrome. Myths: Easy drugs like Marijuana are okay and wont hurt the baby at all. This is false! Marijuana is addictive and can have the same affect on a baby as cocaine!

Symptoms
The types of symptoms that

the baby will exhibit depends on a few factors: the type of drug that was used by the mother how the mothers body reacts to the drug the amount of drug taken by the mother the length of time the mother was using the drug, and the time of birth of the child (full-term or premature).

More Symptoms
Symptoms can be hard to

decipher because many babies exhibit similar symptoms due to a wide variety of problems. Sleep problems Slow weight gain Stuffy nose, sneezing Sweating Trembling (tremors) Vomiting

Blotchy skin coloring

(mottling) Diarrhea Excessive or high-pitched crying Excessive sucking Fever Hyperactive reflexes Increased muscle tone Irritability Poor feeding Rapid breathing Seizures

Next Steps
If NAS is a possibility with

your child, have your baby checked by a pediatrician immediately. Symptoms may begin as soon as 48 hours after birth or as late as two weeks. A pediatrician may administer the following tests: Toxicology screen of the first bowel movements. Urine test. A Neonatal Abstinence Scoring test that scores on the severity of the symptoms.

Treatment: At Home
The treatment for Gently rocking the child Reducing noise and

Neonatal Abstinence Syndrome depends on the severity of the case and the type of drugs involved. The babys overall health will determine the type of treatment provided by the pediatrician.

lights Swaddling the baby in a blanket

Medical Treatments
Medicine to treat

withdrawal such as Morphine and Methadone. A doctor may prescribe a similar drug to the type that was used during pregnancy and decrease the dosage slowly over time. Because NAS often causes premature and low-birth weight babies, high-calorie formula may be given to the child.

Universal Drug Screening

Where Is This Happening?

Seven hospitals in Greater Cincinnati began universal

drug testing on all expectant mothers beginning September 1. Hospitals participating in the new drug testing policy include:

Cincinnati Childrens University of Cincinnati Medical Center Bethesda North Hospital Good Samaritan Hospital Mercy Health Anderson Mercy Health Fairfield St. Elizabeth.

Why Is This Happening?

Developed by a group of

hospitals working with the Greater Cincinnati Health Council. Cincinnati Childrens, which provides neonatology services to nearly all maternity units in the region, coordinated research that supports the new policy.

The new approach to

drug screening is one part of a coordinated response to a surge of drug-addicted infants born in the region. The number of exposed babies has quadrupled in about four years

10.8 infants per 1,000 births in 2009 46 per 1,000 births in the first three months of 2013

Benefits To Testing
Testing is designed to help Surge in drug-exposed

the family, the mother and the infant! Hospital can monitor the infant after birth and provide the appropriate care if the infant begins to show withdrawal symptoms.

infants creates a healthcare burden

Scott Wexelblatt, MD medical director of regional newborn services at Cincinnati Childrens

Average length of stay is 16.4 days for an infant suffering from opiate withdrawal Only 3.3 days for infants without NAS Average cost of a hospital stay for NAS is about $53,400 Only $9,500 for infants without NAS

The Testing
The drug testing will become standard procedure for

the hospitals but is not mandatory for individuals.

Any patient can refuse the test.

Expected to detect drug-exposed newborns who

otherwise might be sent home before NAS symptoms emerge. Pilot research:

As many as 20 percent of infants exposed to opioids who were detected by universal screening would not have been detected by existing hospital practices and procedures. 33 percent of infants exposed to other drugs would not have been detected without universal testing

Citations
Massatti, R., Falb, M., Yors, A., Potts, L., Beeghly, C. & Starr, S.

(2013, November). Neonatal abstinence syndrome and drug use among pregnant women in Ohio, 2004-2011. Columbus, OH: Ohio Department of Mental Health and Addiction Services Neonatal Abstinence Syndrome. The National Institute of Health. January 2012. Web. Nov 2013. Neonatal Abstinence Syndrome and Drug Use Among Pregnant Women in Ohio 2004-2011. Ohio Mental Health Addiction Services. Nov 2013. Web. Universal drug testing for expectant mothers begins Sept. 1. Cincinnati Childrens. Web. Nov 2013. Local Hospitals Launch Universal Drug Testing to Better Care for Babies Born Addicted to Drugs. Greater Cincinnati Health Council. September 2013. Web. Nov 2013.