Children born dependent on opiates suffer withdrawal and other health problems, including vomiting and diarrhea, shortly after birth. They are known to have high-pitched, inconsolable screams, and their symptoms can last days or even weeks.
The new research adds another layer of context to their long-term health outlook. One recent study in the United States, where an opioid epidemic has swept across the country, found that rates of neonatal abstinence syndrome have increased nearly fivefold over the past decade.
For the study, published Monday (PDF) in the journal Pediatrics, the authors examined school test data for all children born in the state of New South Wales between 2000 and 2006, looking at reading and math test scores in third, fifth and seventh grades.
The study examined more than 2,200 children born with neonatal abstinence syndrome and compared their test results with those of more than 4,300 who do not have NAS, as well as the test results of 598,000 children in New South Wales.
The biggest takeaway, the authors concluded, was that children born with neonatal abstinence syndrome, or NAS, performed progressively worse on testing as they got older. By seventh grade, nearly 38% of the NAS children did not meet the minimum standards in at least one testing category.
"This difference was progressive," the authors said. "By the time the children reached grade 7, scores for children with NAS were lower than scores for other children in grade 5."
The authors said children who are born addicted to opiates and their families "must be identified early and provided with support to minimize the consequences of poor education outcomes."
The authors acknowledged that other factors, such as home environment or parents' education level, may have contributed to the lower test scores. However, they said the results suggest that "children with NAS must be supported beyond withdrawal to minimize the risk of school failure and its consequences."
Although there are no boundaries when it comes to addiction, rural US hospitals have been hit hardest by the opiate crisis because of the strain on already tight resources.
It's a familiar problem for Dr. Sean Loudin, the medical director of a neonatal therapeutic unit at Cabell Huntington Hospital in Huntington, West Virginia, and a separate facility called Lily's Place. He said he sees one out of every 10 children born dependent on heroin or some other opiate.
"When they are born, because they're no longer being exposed to an opiate, they're going to go through withdrawal. That is what we deal with. We deal with babies going through withdrawal."
Text Description of Infographic
Use of opiates during pregnancy can result in a drug withdrawal syndrome in newborns called neonatal abstinence syndrome (NAS). A new study to determine the extent, context, and costs of NAS found that incidence of NAS is rising in the United States. There was a five-fold increase in the proportion of babies born with NAS from 2000 to 2012, when an estimated 21,732 infants were born with NAS —equivalent to one baby suffering from opiate withdrawal born every 25 minutes. Newborns with NAS were more likely than other babies to also have low birthweight and respiratory complications. The number of delivering mothers using or dependent on opiates rose nearly five-fold from 2000 to 2009, to an estimated 23,009. In 2012, newborns with NAS stayed in the hospital an average of 16.9 days (compared to 2.1. days for other newborns), costing hospitals an estimated $1.5 billion; the majority of these charges (81%) were paid by state Medicaid programs, reflecting the greater tendency of opiate-abusing mothers to be from lower-income communities. The rising frequency (and costs) of drug withdrawal in newborns points to the need for measures to reduce antenatal exposure to opiates.
Top Graph: Every 25 minutes, 1 baby is born suffering from opiate withdrawal.
Bottom Left Graph: Average length or cost of hospital stay graph. Newborns with NAS stayed in the hospital for an average of 16.9 days compared to 2.1 days for those without NAS. The hospital costs for newborns with NAS were $66,700 on average compared to $3,500 for those without NAS.
Bottom Right Graph: NAS and maternal opiate use on the rise graph.
The rate of babies born with NAS per 1,000 hospital births was 1.2 in 2000, 1.5 in 2003, 1.96 in 2006, 3.39 in 2009 and 5.8 in 2012. The rate of maternal opiate use per 1,000 hospital births was 1.19 in 2000, 1.26 in 2003, 2.52 in 2006, and 5.63 in 2009.
References:Patrick et. Al., JAMA 2012, Patrick et. Al., Journal of Perinatology 2015
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