2021 AM Posters-A Life-Saving Diagnosis Clinical Considerations for Prenatal

A Life-Saving Diagnosis Clinical Considerations for Prenatal

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This study aimed to evaluate infant mortality among infants exposed to opioids in utero, specifically comparing mortality risk in infants with and without a diagnosis of neonatal withdrawal syndrome (NOWS) after birth. The study found that among the 1,129,032 mother-infant pairs included, 7,207 had prenatal opioid exposure, with 4,238 infants diagnosed with NOWS and 2,969 infants not diagnosed with NOWS. The infant mortality rate was highest in opioid-exposed infants not diagnosed with NOWS (20 per 1,000 live births), compared to infants diagnosed with NOWS (11 per 1,000) and infants with no prenatal opioid exposure (6 per 1,000).<br /><br />The study highlights the need for health policies and programs that support women with opioid use disorder and their infants in the postnatal period. The increase in mortality rates among opioid-exposed infants not diagnosed with NOWS suggests the presence of protective factors in infants diagnosed with NOWS. The post-partum period is particularly vulnerable for mother-infant pairs, with increased rates of overdose, treatment discontinuation, and maternal depression.<br /><br />The study recommends extending the treatments and supports provided to infants diagnosed with NOWS to infants exposed to opioids in utero, even if they are not diagnosed with NOWS. Universal screening for opioid use disorder during pregnancy, as well as longitudinal care for women and their families throughout pregnancy, is crucial. Infants and their families should have targeted clinical interventions, public health programs, and supportive health policies, including pharmacotherapy, mental health treatment, overdose education, and community supports.<br /><br />In summary, this study demonstrates the increased risk of mortality in infants exposed to opioids in utero, particularly in those not diagnosed with NOWS. It emphasizes the need for interventions that support women with opioid use disorder and their infants, regardless of the severity of neonatal opioid withdrawal.

Keywords

infant mortality

opioids in utero

neonatal withdrawal syndrome

prenatal opioid exposure

infant diagnosis

mortality rate

health policies

postnatal period

protective factors

post-partum period

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