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Credit: Pediatric Academic Societies
TORONTO, May 5, 2018 - According to a new study, mothers of infants with neonatal abstinence syndrome (NAS) have a higher prevalence of mental health diagnoses in the first two months postpartum, in comparison to mothers of infants without NAS. Findings from the study will be presented during the Pediatric Academic Societies (PAS) 2018 Meeting in Toronto.
Women with a history of substance use disorders (SUD) have a high incidence of coexisting psychiatric and mood disorders as well as difficulty managing adversity. Such characteristics may affect the ability of pregnant women with histories of SUD to cope with an infant with NAS, particularly one with a protracted neonatal intensive care unit (NICU) course, exacerbating symptoms of mental health disorders.
The research data was extracted from Truven Marketscan® Commercial Claims and Encounters database from 2005 to 2013. Newborns with NAS were identified using the ICD-9 code 779.5 (drug withdrawal in the newborn). Newborn inclusion criteria included a delivery code, gestational age code or other perinatal code, gestational age of 35 weeks or greater, known discharge status and linkage to mother's records. Maternal inclusion criteria were inpatient claim indicating delivery of newborn and continuous enrollment nine months prior to and one year after delivery. Infants with significant medical diseases were excluded. Researchers matched each mother of a newborn with NAS to a mother of a newborn without NAS on age at delivery, birth year, gestational age, NICU stay and maternal mental health outcomes in the nine months prior to delivery.
The study found 338 mother-infant pairs met all inclusion and exclusion criteria and were matched to one control, and 246 (73 percent) of the infants with NAS had a NICU stay. Median length of stay for these infants was 10 days compared to three days for infants with no admission to the NICU (p<0.001). Compared to matched controls, mothers of an infant with NAS were significantly more likely (p<0.01 for all of the following) to have claims for major depression (33 percent vs. 11 percent), postpartum depression (7 percent vs. 0 percent), anxiety (27 percent vs. 1 percent) and adjustment reaction (9 percent vs. 4 percent).
"In the presence of the ongoing opioid epidemic across North America and beyond, evaluation of the far-reaching consequences of this crisis is crucial," said Dr. Tammy Corr, the lead author of the study. "For new mothers affected by substance use disorders, careful, repeated mental health screenings over the course of the first year of her baby's life may be beneficial to both the mother and her infant."
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Dr. Corr will present the abstract, "Mental Health Outcomes of Mothers with Infants Diagnosed with Neonatal Abstinence Syndrome," during the PAS 2018 Meeting on Monday, May 7 at 11:30 a.m. EDT. Reporters interested in an interview with Dr. Corr should contact PAS2018@piercom.com.
Please note: Only the abstract is being presented at the meeting. In some cases, the researcher may have additional data to share with media.
The PAS 2018 Meeting, taking place in Toronto on May 5-8, 2018, brings together thousands of pediatric scientists and other health care providers to improve the health and well-being of children worldwide. For more information about the PAS 2018 Meeting, please visit http://www.pas-meeting.org.
About The Pediatric Academic Societies (PAS) Meeting The Pediatric Academic Societies (PAS) Meeting brings together thousands of pediatricians and other health care providers united by a common mission: improve the health and well-being of children worldwide. This international gathering includes researchers, academics, as well as clinical care providers and community practitioners. Presentations cover issues of interest to generalists as well as topics critical to a wide array of specialty and sub-specialty areas. The PAS Meeting is produced through a partnership of four pediatric organizations that are leaders in the advancement of pediatric research and child advocacy: American Pediatric Society, Society for Pediatric Research, Academic Pediatric Association and American Academy of Pediatrics. For more information, please visit http://www.pas-meeting.org. Follow us on Twitter @PASMeeting and #PAS2018, or like us on Facebook.
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Abstract: Mental Health Outcomes of Mothers with Infants Diagnosed with Neonatal Abstinence Syndrome
Background: Women with a history of substance use disorders (SUD) have a high incidence of coexisting psychiatric and mood disorders as well as difficulty managing adversity. These characteristics may affect the ability of a pregnant woman with a history of SUD to cope with an infant with neonatal abstinence syndrome (NAS), particularly one with a protracted Neonatal Intensive Care Unit (NICU) course, exacerbating symptoms of mental health disorders.
Objective: Determine the incidence of mental health diagnoses in the first 12 months postpartum in mothers of an infant with NAS compared to matched controls of mothers with an infant without NAS.
Design/Methods: Data were extracted from Truven MarketScan® Commercial Claims and Encounters database for the years 2005-2013. Newborns with NAS were identified using the ICD-9 code 779.5 (drug withdrawal in the newborn). Newborn inclusion criteria were a delivery code, gestational age code or other perinatal code, gestational age of 35 weeks or greater, known discharge status and linkage to mother's records. Maternal inclusion criteria were inpatient claim indicating delivery of newborn and continuous enrollment 9 months prior to and 1 year after delivery. Infants with significant medical diseases were excluded. We matched each mother of a newborn with NAS to a mother of a newborn without NAS on age at delivery, birth year, gestational age, NICU stay and maternal mental health outcomes in the 9 months prior to delivery.
Results: 338 mother-infant pairs met all inclusion and exclusion criteria and were matched to one control. 246 (73%)of the infants with NAS had a NICU stay. Median length of stay for these infants was 10 days compared to 3 days for infants with no admission to the NICU (p<0.001). Compared to matched controls, mothers of an infant with NAS were significantly more likely (p<0.01 for all of the following) to have claims for major depression (33% vs. 11%), postpartum depression (7% vs. 0%), anxiety (27% vs. 1%), and adjustment reaction (9% vs. 4%).
Conclusion(s): Mothers of infants with NAS have a higher prevalence of mental health diagnoses in the first 12 months postpartum compared to mothers of infants without NAS. Programs that provide support to new mothers with a history of SUD may be beneficial to both the mother and her infant.
Authors: Tammy Corr, Eric Schaefer, Christopher Hollenbeak, Douglas Leslie