Characterization of Neonatal Abstinence Syndrome in Arizona from 2010-2017

This studv aimed to characterize the population of newborn infants with neonatal abstinence svndrome (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. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This work was supported by a Pilot grant project to Dr. Crystal Hepp as part of the NIH/NIMHD RCMI U54MD012388 to Julie Baldwin and Diane Stearns. ### Author Declarations All relevant ethical guidelines have been followed; any necessary IRB and/or ethics committee approvals have been obtained and details of the IRB/oversight body are included in the manuscript. Yes All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes Raw data were generated at Arizona Department of Health Services using hospital discharge records. Derived data supporting the findings of this study are available from the corresponding author CMH on reasonable request.