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. 2018 Sep;142(3):e20180562.
doi: 10.1542/peds.2018-0562.

Educational Disabilities Among Children Born With Neonatal Abstinence Syndrome

Mary-Margaret A Fill  1   2   3 , Angela M Miller  2 , Rachel H Wilkinson  4 , Michael D Warren  2 , John R Dunn  2   3 , William Schaffner  3 , Timothy F Jones  2   3
Affiliations

Educational Disabilities Among Children Born With Neonatal Abstinence Syndrome

Mary-Margaret A Fill et al. Pediatrics. 2018 Sep.

Abstract

Background: Neonatal abstinence syndrome (NAS) is a postnatal drug withdrawal syndrome that can occur after intrauterine opioid exposure. Adverse neurobehavioral outcomes have been documented in infants with NAS; however, educational outcomes have not been thoroughly examined. We analyzed Tennessee data to understand the need for special educational services among infants who are born with NAS.

Methods: By using Tennessee Medicaid and birth certificate data, infants who were born in Tennessee between 2008 and 2011 with a history of NAS were matched (1:3) to infants who were born during the same period without a history of NAS. Groups were matched on the basis of sex, race and/or ethnicity, age, birth region of residence, and Medicaid enrollment status. Data were linked to Tennessee Department of Education special education data during early childhood (3-8 years of age). Conditional multivariable logistic regression was used to assess associations between NAS and selected special education outcomes.

Results: A total of 1815 children with a history of NAS and 5441 children without NAS were assessed. Children with NAS were significantly more likely to be referred for a disability evaluation (351 of 1815 [19.3%] vs 745 of 5441 [13.7%]; P < .0001), to meet criteria for a disability (284 of 1815 [15.6%] vs 634 of 5441 [11.7%]; P < .0001), and to require classroom therapies or services (278 of 1815 [15.3%] vs 620 of 5441 [11.4%]; P < .0001). These findings were sustained in a multivariable analysis, with multiple models controlling for maternal tobacco use, maternal education status, birth weight, gestational age, and/or NICU admission.

Conclusions: Results of this novel analysis linking health and education data revealed that children with a history of NAS were significantly more likely to have a subsequent educational disability.

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Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
Construction of the data set for analysis. ICD-9, International Classification of Diseases, Ninth Revision; TN, Tennessee.
See this image and copyright information in PMC

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