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Neonatal abstinence syndrome and infant mortality and morbidity: a population-based study.
Lisonkova, Sarka; Wen, Qi; Richter, Lindsay L; Ting, Joseph Y; Lyons, Janet; Mitchell-Foster, Sheona; Oviedo-Joekes, Eugenia; Muraca, Giulia M; Bayrampour, Hamideh; Cattoni, Eric; Abrahams, Ronald.
Afiliação
  • Lisonkova S; Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada.
  • Wen Q; School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
  • Richter LL; Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada.
  • Ting JY; Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada.
  • Lyons J; Department of Pediatrics, University of Alberta, Edmonton, AB, Canada.
  • Mitchell-Foster S; Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada.
  • Oviedo-Joekes E; Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada.
  • Muraca GM; Northern Medical Program, University of British Columbia, Prince George, BC, Canada.
  • Bayrampour H; School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
  • Cattoni E; Departments of Obstetrics and Gynecology, and Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
  • Abrahams R; Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
Front Pediatr ; 12: 1394682, 2024.
Article em En | MEDLINE | ID: mdl-39081925
ABSTRACT

Background:

Infant health among newborns with neonatal abstinence syndrome (NAS) has been understudied. We examined infant mortality and hospitalizations among infants diagnosed with NAS after birth.

Methods:

All live births in British Columbia (BC), Canada, for fiscal years from 2004-2005 to 2019-2020, were included (N = 696,900). NAS was identified based on International Classification of Diseases, version 10, Canadian modification (ICD-10-CA) codes; the outcomes included infant death and hospitalizations during the first year of life, ascertained from BC linked administrative data. Generalized estimating equation models were used to adjust for maternal factors.

Results:

There were 2,439 infants with NAS (3.50 per 1,000 live births). Unadjusted for other factors, infant mortality was 2.5-fold higher in infants with vs. without NAS (7.79 vs. 3.08 per 1,000 live births, respectively) due to increased post-discharge mortality NAS (5.76 vs. 1.34 per 1,000 surviving infants, respectively). These differences diminished after adjustment adjusted odds ratio (AOR) for infant death was 0.85 [95% confidence interval (CI) 0.52-1.39]; AOR for post-discharge death was 1.75 (95% CI 1.00-3.06). Overall, 22.3% infants with NAS had at least one hospitalization after post-neonatal discharge, this proportion was 10.7% in those without NAS. During the study period, discharge to foster care declined from 49.5% to 20.3% in infants with NAS.

Conclusion:

Unadjusted for other factors, infants with NAS had increased post-discharge infant mortality and hospitalizations during the first year of life. This association diminished after adjustment for adverse maternal and socio-medical conditions. Infants with NAS had a disproportionately higher rate of placement in foster care after birth, although this proportion declined dramatically between 2004/2005 and 2019/2020. These results highlight the importance of implementing integrated care services to support infants born with NAS and their mothers during the first year of life and beyond, even though NAS itself is not independently associated with increased infant mortality.
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Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2024 Tipo de documento: Article