Diagnoses during the First Three Years of Life for Children with Prenatal Opioid Exposure and Neonatal Abstinence Syndrome Using a Large Maternal Infant Data Hub

Abstract

Purpose: The purpose of this study was to examine patterns of health and developmental outcomes in children with prenatal opioid exposure (POE) and neonatal abstinence syndrome (NAS) compared to children without exposure during the first three years of life.

Design and methods: This was a secondary data analysis of the Maternal and Infant Data Hub (MIDH), a de-identified dataset originating from the Midwest region of the United States, consisting of newborn billing records and corresponding maternal and child electronic medical records. For these analyses, the repository included data on more than 20,000 children born between 2013 and 2019. Diagnoses were identified with International Classification of Diseases, ninth and tenth Revision, Clinical Modification codes (ICD-9/10-CM). Firth logistic regression was used to assess whether incidence of each diagnosis code differed by exposure group.

Results: Among 20,389 children in the dataset, 13,173 were unexposed; 455 were POE, and 199 were POE + NAS. There were significant differences in frequency of diagnoses between groups, specifically regarding growth and development, infection, mental health, musculoskeletal, neonatal, sensory, and social issues. When comparing exposed groups, children with POE + NAS experienced more negative health outcomes than children with only POE across all years.

Conclusions: This study implicates POE as a significant variable associated with many health and developmental outcomes of children during the first three years of life.

Practice implications: It is crucial to understand and identify health risks observed more frequently in exposed children during such a critical period of growth and brain development.

Keywords: Development; Health; ICD codes; Universal maternal drug testing.