The association between intrauterine exposure to opioids, tobacco, alcohol, and cannabis and length of birth hospitalization among neonates without NOWS

• Type of Material: Article
• Authors: Steven J. Ondersma, Michigan State University; Amii M. Kress, Johns Hopkins Bloomberg School of Public Health; Annemarie Stroustrup, Zucker School of Medicine at Hofstra; Robert D. Annett, University of New Mexico; Lyndsay A. Avalos, Kaiser Permanente Northern California; Maria Talavera-Barber, University of South Dakota; Patricia Brennan, Emory University; Carlos A. Camargo Jr., Massachusetts General Hospital; Elisabeth Conradt, Duke University; Anne Lang Dunlop, Emory University; Amy J. Elliott, University of South Dakota; Monique M. Hedderson, Kaiser Permanente Northern California; Ximin Li, Johns Hopkins Bloomberg School of Public Health; Monica McGrath, Johns Hopkins Bloomberg School of Public Health; Ruby H.N. Nguyen, University of Minnesota; Grier P. Page, Research Triangle Institute; Sheela Sathyanarayana, Seattle Children’s Research Institute; Barry Lester, Brown University
• Language: English
• Date: 2023-05-09
• Publisher: Springer Nature
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2023, The Author(s), under exclusive licence to Springer Nature America, Inc.
• Final Published Version (URL): https://doi.org/10.1038/s41372-023-01694-5
• Title of Journal or Parent Work: Journal of Perinatology
• Volume: 43
• Issue: 7
• Start Page: 949
• End Page: 951
• Grant/Funding Information: Research reported in this publication was supported by the Environmental influences on Child Health Outcomes (ECHO) Program, Office of The Director, National Institutes of Health, under Award Numbers U2COD023375 (Coordinating Center), U24OD023382 (Data Analysis Center), U24OD023319 (PRO Core), UH3OD023253 (PI Camargo), UH3OD023318 (PI Dunlop), and UH3OD023279 (PI Elliot). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
• Keywords: length of stay; neonatal opioid withdrawal syndrome (NOWS); hospitalization; birth
• Research Categories: Health Sciences, Obstetrics and Gynecology; Health Sciences, Pharmacology

Abstract

Birth hospitalization length of stay (LOS) is extended for infants with neonatal opioid withdrawal syndrome (NOWS),1 raising health care costs and complicating efforts to promote maternal-infant bonding.1–2 However, many infants exposed to opioids do not develop NOWS. The overall costs of intrauterine opioid exposure may be significantly greater if infants who do not develop withdrawal symptoms also have an increased LOS due to observation for the emergence of NOWS or other medical or social complications. Using data from the Environmental influences on Child Health Outcomes (ECHO)-wide cohort study funded by the National Institutes of Health, we evaluated whether opioid exposure not resulting in NOWS was associated with a longer LOS. We also performed similar evaluations of tobacco, alcohol, and cannabis, and considered the effect of combined exposures.