Characterization of Neonatal Abstinence Syndrome in Arizona from 2010-2017

This study aimed to characterize the population of newborn infants with neonatal abstinence syndrome (NAS) and mothers who were opioid dependent at the time of giving birth, in Arizona. We analyzed approximately 1.2 million electronic medical records from the Arizona Department of Health Services Hospital Discharge Database to identify patterns and disparities across socioeconomic, ethnic/racial, and/or geographic groupings. In addition, we identified comorbid conditions that are differentially associated with NAS in infants or opioid dependence in mothers. Our analysis was designed to assess whether indicators such as race/ethnicity, insurance payer, marital status, and comorbidities are related to the use of opioids while pregnant. In this paper, we describe a population of mothers who are opioid dependent at the time of giving birth and infants who experience withdrawal due to opioid exposure in utero. While there have been studies of national trends in this population (see Patrick et al.), regional trends and issues are less well understood. Using data from the Arizona Department of Health Services Hospital Discharge Database, we find that women and infants who are non-Hispanic White and economically disadvantaged, tend be part of our populations of interest more frequently than expected. Additionally, we find that women who are opioid dependent at the time of giving birth are unmarried more often than expected, and we suggest that marital status could be a proxy for support. Finally, we report comorbidities, some of which have not been previously reported, associated with infants who have NAS and mothers who are opioid dependent.