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Infants Experiencing Opioid Withdrawal More Often Treated in Poorer Quality Hospitals

The research from Penn Nursing analyzed information from three datasets accounting for 25 percent of U.S. births annually.

Babies exposed to opioids prenatally often experience withdrawal symptoms once they’re born. “These symptoms are physiologic, such as a higher heart rate, neurologic, such as difficulty feeding, and gastrointestinal, such as spitting up and diarrhea,” says Penn Nursing researcher Eileen Lake. “There are also behavioral symptoms: being hard to console, a piercing cry, jerky body movements.” When enough of the symptoms surface, a newborn may get diagnosed with neonatal abstinence syndrome (NAS).

Incidence of NAS has increased five-fold in the past decade, in line with an uptick in opioid use and addiction in the United States, says Lake, who studies how nursing care across hospitals influences outcomes for at-risk infants. In a new area of research, Lake, along with Penn Nursing fellows Rachel French and Rebecca Clark, Kathleen O’Rourke of the Hospital of the University of Pennsylvania, and Scott Lorch of the Children’s Hospital of Philadelphia, wanted to better understand where newborns with NAS most often receive care.

The research team analyzed three datasets that included more than 3,100 babies diagnosed with NAS at 266 different locations. They found that these newborns were more frequently cared for in poorer quality hospitals, which have been linked to worse patient outcomes. They published their findings in Hospital Pediatrics, a journal of the American Academy of Pediatrics.

“This work really began a decade ago,” Lake says. At the time, she and colleagues were looking at how nursing care might benefit very-low-birthweight infants, those weighing less than 4 pounds at birth. Repeatedly, nurses they interviewed for that research mentioned the need to somehow denote when they had a newborn in opioid withdrawal on their unit.

This is an excerpt from a longer article that originally appeared in Penn Today. It was written by Michele Berger, senior science news officer in University Communications.