Intrauterine Substance Exposure and the Risk for Subsequent Physical Abuse Hospitalizations.
Acad Pediatr
; 20(4): 468-474, 2020.
Article
en En
| MEDLINE
| ID: mdl-32081768
ABSTRACT
OBJECTIVE:
To describe the relative risk for a physical abuse hospitalization among substance exposed infants (SEI) with and without neonatal abstinence syndrome (NAS).METHODS:
We created a nationally representative US birth cohort using the 2013 and 2014 Nationwide Readmissions Databases. International Classification of Diseases, Ninth Revision, Clinical Modification codes were used to identify newborns, predictor variables, and subsequent hospitalizations for physical abuse within 6 months of discharge from newborns' birth hospitalization. Predictor variables included newborn demographics, prematurity or low birth weight, and intrauterine substance exposure non-SEI, SEI without NAS, and SEI with NAS. Multiple logistic regression calculated adjusted relative risks and 95% confidence intervals. A subanalysis of newborns with narcotic exposure was performed.RESULTS:
There were 3,740,582 newborns in the cohort; of which 13,024 (0.4%) were SEI without NAS and 20,196 (0.5%) SEI with NAS. Overall, 1247 (0.03%) newborns were subsequently hospitalized for physical abuse within 6 months. Compared to non-SEI, SEI with NAS (adjusted relative risks 3.84 [95% confidence intervals 2.79-5.28]) were at increased risk for having a subsequent hospitalization for physical abuse, but SEI without NAS were not. A similar pattern was observed among narcotic-exposed infants; infants with NAS due to narcotics were at increased risk, but narcotic-exposed infants without NAS were not.CONCLUSIONS:
Our results suggest that newborns diagnosed with NAS are at increased risk of physical abuse during early infancy, above that of substance-exposed infants without NAS. These results should improve the identification of higher-risk infants who may benefit from more rigorous safety planning and follow-up care.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
2_ODS3
/
8_ODS3_consumo_sustancias_psicoactivas
Problema de salud:
2_sustancias_psicoativas
/
8_opioid_abuse
Asunto principal:
Síndrome de Abstinencia Neonatal
/
Abuso Físico
Tipo de estudio:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Humans
/
Infant
/
Newborn
Idioma:
En
Revista:
Acad Pediatr
Año:
2020
Tipo del documento:
Article