Punitive reporting tied to increased risk for neonatal abstinence syndrome

  • Faherty LJ & al.
  • JAMA Netw Open
  • 1 Nov 2019

  • International Clinical Digest
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Takeaway

  • Punitive policies on opioid use during the prenatal period do not reduce rates of neonatal abstinence syndrome (NAS).

Why this matters

  • Punitive policies may deter women from seeking prenatal care.

Key results

  • Policies that criminalised opioid use increased rates of NAS during the first year after enactment (aOR, 1.25; P=.007) and >1 year after enactment (aOR, 1.33; P<.001>
  • Policies requiring reporting of perinatal opioid use did not affect rates of NAS.

Study design

  • Repeated cross-sectional study.
  • Rates of NAS were identified from the Healthcare Cost and Utilization Project's State Inpatient Databases using ICD codes.
  • A convenience sample from different time periods in 8 states that varied in their enactment of punitive or reporting policies was examined.
  • Effects of 2 state policies compared (punitive vs reporting).
  • Funding: the National Institute on Drug Abuse of the National Institutes of Health.

Limitations

  • Results may not be generalizable (only 8 states examined).
  • Misclassification of ICD codes possible.