{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T10:22:25Z","timestamp":1789122145641,"version":"build-2803163510"},"reference-count":66,"publisher":"Georg Thieme Verlag KG","issue":"03","funder":[{"DOI":"10.13039\/100000016","name":"U.S. Department of Health and Human Services","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000016","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","award":["2UG10D024947-03"],"award-info":[{"award-number":["2UG10D024947-03"]}]},{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","award":["3U2COD023375-06S1"],"award-info":[{"award-number":["3U2COD023375-06S1"]}]},{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","award":["3U2COD023375-07S2"],"award-info":[{"award-number":["3U2COD023375-07S2"]}]},{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","award":["U10 HD053089"],"award-info":[{"award-number":["U10 HD053089"]}]},{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","award":["U24 OD024957"],"award-info":[{"award-number":["U24 OD024957"]}]},{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","award":["UG1 HD27853"],"award-info":[{"award-number":["UG1 HD27853"]}]},{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","award":["UG1 HD36790"],"award-info":[{"award-number":["UG1 HD36790"]}]},{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","award":["UG1 HD68278"],"award-info":[{"award-number":["UG1 HD68278"]}]},{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","award":["UG1 HD87226"],"award-info":[{"award-number":["UG1 HD87226"]}]},{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","award":["UG1 OD024954"],"award-info":[{"award-number":["UG1 OD024954"]}]},{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","award":["UG1 OD024955"],"award-info":[{"award-number":["UG1 OD024955"]}]},{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","award":["UG1 OD024959"],"award-info":[{"award-number":["UG1 OD024959"]}]},{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","award":["UL1 TR105"],"award-info":[{"award-number":["UL1 TR105"]}]},{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","award":["UL1 TR77"],"award-info":[{"award-number":["UL1 TR77"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Determine the relationship between maternal Social Deprivation Index (SDI), a composite measure of area-level deprivation, and maternal characteristics and infant outcomes for mother\u2013infant dyads with perinatal opioid exposure.<\/jats:p>\n                  <jats:p>Post hoc secondary analysis of 1,298 mother\u2013infant dyads in the ESC-NOW study, a multicenter, stepped-wedge cluster-randomized controlled trial (2020\u20132022) conducted at 26 U.S. study hospitals. The 2016 American Community Survey was used to develop SDI scores based on the maternal zip code of residence at the time of delivery. Outcomes evaluated included receipt of pharmacologic treatment for neonatal opioid withdrawal syndrome (PT), receipt of breastmilk during hospital stay, direct breastfeeding at discharge, discharge disposition, and length of stay for infants who received PT (length of hospital stay, LOS).<\/jats:p>\n                  <jats:p>The median SDI score was 62 on a scale of 100. The high SDI group, with a score above the SDI median and more social deprivation, was less likely to receive adequate prenatal care or medication for opioid use disorder and more likely to be Black and\/or Hispanic. The mean proportion of infants in the high SDI group was 6.2% points (relative risk [RR]: 0.89; 95% confidence interval [CI]: 0.80, 0.98) less likely to receive breastmilk during the newborn hospitalization and 7.3% points (RR: 0.91; 95% CI: 0.87, 0.96) less likely to be discharged home with a biological parent. There was no difference between the high and low SDI groups in receipt of PT, direct breastfeeding at discharge, or LOS.<\/jats:p>\n                  <jats:p>Mothers from high SDI communities with opioid exposure during pregnancy were less likely to receive the established standard of care and more likely to be Black and\/or Hispanic. Infants born to these mothers were less likely to receive breastmilk and\/or to be discharged home with a biological parent. Targeting interventions to mitigate the impact of social deprivation in high SDI communities may improve outcomes for opioid-exposed infants and their mothers.<\/jats:p>","DOI":"10.1055\/a-2622-3839","type":"journal-article","created":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T20:08:52Z","timestamp":1748462932000},"page":"383-395","source":"Crossref","is-referenced-by-count":1,"title":["Maternal Area of Residence and Outcomes for Mother\u2013Infant Dyads with Perinatal Opioid Exposure"],"prefix":"10.1055","volume":"43","clinical-trial-number":[{"clinical-trial-number":"nct04057820","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-8712-2014","authenticated-orcid":false,"given":"Adrienne","family":"Pahl","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Robert Larner, M.D., College of Medicine at the University of Vermont, Burlington, Vermont"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhuopei","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, University of Arkansas for Medical Sciences College of Medicine, Little Rock, Arkansas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leslie W.","family":"Young","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Robert Larner, M.D., College of Medicine at the University of Vermont, Burlington, Vermont"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kara Wong","family":"Ramsey","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Kapiolani Medical Center for Women and Children, Honolulu, Hawaii"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bonny L.","family":"Whalen","sequence":"additional","affiliation":[{"name":"Pediatric Hospital Medicine, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akshatha","family":"Akshatha","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Kapiolani Medical Center for Women and Children, Honolulu, Hawaii"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristen L.","family":"Benninger","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Nationwide Children's Hospital and The Ohio State University, Columbus, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7564-8395","authenticated-orcid":false,"given":"Camille M.","family":"Fung","sequence":"additional","affiliation":[{"name":"Department of Pediatric Neonatology, University of Utah School of Medicine, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meghan P.","family":"Howell","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Tulane University School of Medicine, New Orleans, Louisiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofia","family":"Markee","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of New Mexico, Albuquerque, New Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2722-0479","authenticated-orcid":false,"given":"Abhik","family":"Das","sequence":"additional","affiliation":[{"name":"Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret M.","family":"Crawford","sequence":"additional","affiliation":[{"name":"Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lillian","family":"Trochinski","sequence":"additional","affiliation":[{"name":"Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4156-8543","authenticated-orcid":false,"given":"Rachel G.","family":"Greenberg","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Songthip T.","family":"Ounpraseuth","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, University of Arkansas for Medical Sciences College of Medicine, Little Rock, Arkansas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie L.","family":"Merhar","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lori A.","family":"Devlin","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Louisville School of Medicine, Louisville, Kentucky"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6646-384X","authenticated-orcid":false,"given":"Kathryn Dee L.","family":"MacMillan","sequence":"additional","affiliation":[{"name":"Pediatric Hospital Medicine, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the Eunice Kennedy Shriver NICHD, Neonatal Research Network, the NIH ECHO Program, IDeA States Pediatric Clinical Trials 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