Babies born to individuals with opioid use disorder at increased mortality risk: JAMA

USA: A new study published in JAMA: Pediatrics has found that infants born to individuals with opioid use disorder (OUD) or with a diagnosis of neonatal opioid withdrawal syndrome (NOWS) are at an increased risk of post-neonatal infant mortality.

The risk of significant long-term outcomes for infants born to opioid use disorder (OUD) parents is not entirely established, the study aimed to assess the risk of post-neonatal infant mortality in infants with NOWS or born to individuals with OUD.

The study, a retrospective cohort study of 390,075 infants born from 2007 to 2018 to mothers enrolled in Tennessee Medicaid, found that all groups exposed to OUD or NOWS had an elevated risk of postneonatal death compared to the unexposed group.

The study identified four groups based on maternal and infant exposure to OUD and NOWS: OUD positive/NOWS positive, OUD positive/NOWS negative, OUD negative/NOWS positive, and OUD negative/NOWS negative.

The study concluded with the following key takeaways:

1. 1317 post-neonatal infant deaths were observed during the study period.

2. The incidence rates of post-neonatal infant deaths were as follows:

3. OUD negative/NOWS negative: 3.47 per 1000 person-years.

4. OUD positive/NOWS positive: 8.41 per 1000 person-years.

5. OUD positive/NOWS negative: 8.95 per 1000 person-years.

6. OUD negative/NOWS positive: 9.25 per 1000 person-years.

7. After adjustment, the risk of post-neonatal death was elevated for all groups compared to the unexposed group.

The findings highlight the need for supportive interventions for individuals with OUD during and after pregnancy to reduce adverse outcomes. Opioid use disorder during pregnancy can lead to various complications, including neonatal opioid withdrawal syndrome and increased risk of infant mortality.

“The study underscores the importance of addressing the opioid epidemic and its impact on maternal and child health. Future research can further evaluate interventions to reduce the risks for infants born to individuals with opioid use disorder and neonatal opioid withdrawal syndrome.” added the researchers of the study.

Reference:

Grossarth S, Osmundson SS, Wiese AD, et al. Maternal Opioid Use Disorder and the Risk of Postneonatal Infant Mortality. JAMA Pediatr. Published online May 08, 2023. doi:10.1001/jamapediatrics.2023.1047