{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T18:48:09Z","timestamp":1792176489955,"version":"4.4.0"},"reference-count":19,"publisher":"Georg Thieme Verlag KG","issue":"04","funder":[{"name":"University of Utah Population Health Research (PHR) Foundation"},{"name":"National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health","award":["5UL1TR001067"],"award-info":[{"award-number":["5UL1TR001067"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:p>\n            Objective\u2003Neonatal opioid withdrawal syndrome (NOWS) describes infants' withdrawal signs and symptoms after birth due to an interruption of prenatal opioid exposure. Many infants with NOWS are also exposed to nonopioids, however. This study was to determine hospital outcomes of infants exposed to opioids alone or coexposed with nonopioid substances (polysubstance).<\/jats:p><jats:p>\n            Study Design\u2003We reviewed infants of \u226534 weeks of gestation with prenatal opioid exposure from April 2015 to May 2018. We compared the median lengths of stay (LOS) and treatment (LOT) and the percentages of infants requiring pharmacologic and adjunctive treatment in infants exposed to opioids alone or polysubstance. We used Wilcoxon's test for continuous outcomes or Chi-squared test for categorical outcomes to determine statistical significance. We used multivariable regression model to calculate each drug category's estimates of adjusted mean ratios for LOS and LOT plus estimates of adjusted odds ratios for pharmacologic\/adjunctive treatments.<\/jats:p><jats:p>\n            Results\u2003Of the 175 infants, 33 (19%) infants had opioid exposure alone. Opioid exposure included short- and\/or long-acting opioids. A total of 142 (81%) had polysubstance exposure with 47% of mothers using nicotine products. We saw similar hospital outcomes between infants exposed to opioids alone or polysubstance; however, a higher percentage of infants with both short- and long-acting opioid exposure required pharmacologic treatment compared with either opioid alone. Focusing on individual drug categories, we detected differential hospital outcomes in which short-acting opioids decreased LOT, whereas long-acting opioids increased LOS, LOT, and need for pharmacologic and adjunctive treatment. Coexposure of opioids with stimulants decreased LOT and reduced need for adjunctive treatment. Coexposures with antidepressants increased LOT, while with antiepilepetics increased LOS.<\/jats:p><jats:p>\n            Conclusion\u2003Because infants with NOWS often have coexposures to other nonopioid substances, appreciating the associated risks of individual or combination of drugs in modulating hospital outcomes may help counsel families on their infants' expected hospital course.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/s-0040-1716490","type":"journal-article","created":{"date-parts":[[2020,9,6]],"date-time":"2020-09-06T22:33:05Z","timestamp":1599431585000},"page":"387-393","source":"Crossref","is-referenced-by-count":9,"title":["Hospital Outcomes of Infants with Neonatal Opioid Withdrawal Syndrome at a Tertiary Care Hospital with High Rates of Concurrent Nonopioid (Polysubstance) Exposure"],"prefix":"10.1055","volume":"39","author":[{"given":"Erin","family":"Morris","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Residency & Fellowship Program, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tyler","family":"Bardsley","sequence":"additional","affiliation":[{"name":"Division of Epidemiology, University of Utah Study Design and Biostatistics Center, University of Utah School of Medicine, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krista","family":"Schulte","sequence":"additional","affiliation":[{"name":"College of Nursing, University of Utah, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanette","family":"Seidel","sequence":"additional","affiliation":[{"name":"College of Nursing, University of Utah, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie H.","family":"Shakib","sequence":"additional","affiliation":[{"name":"Division of General Pediatrics, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen F.","family":"Buchi","sequence":"additional","affiliation":[{"name":"Division of General Pediatrics, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah"}],"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":"Division of Pediatric Neonatology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2020,9,6]]},"reference":[{"issue":"31","key":"ref1","first-page":"845","article-title":"Opioid use disorder documented at delivery hospitalization - United States, 1999\u20132014","volume":"67","author":"S Haight","year":"2018","journal-title":"Centers Dis Control Prevent MMWR"},{"issue":"02","key":"ref2","doi-asserted-by":"crossref","first-page":"e540","DOI":"10.1542\/peds.2011-3212","article-title":"Neonatal drug withdrawal","volume":"129","author":"M L Hudak","year":"2012","journal-title":"Pediatrics"},{"issue":"02","key":"ref3","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1097\/MOP.0000000000000589","article-title":"Neonatal abstinence syndrome: an update","volume":"30","author":"L A Sanlorenzo","year":"2018","journal-title":"Curr Opin Pediatr"},{"issue":"02","key":"ref4","doi-asserted-by":"crossref","first-page":"e547","DOI":"10.1542\/peds.2013-3524","article-title":"Neonatal abstinence syndrome","volume":"134","author":"P Kocherlakota","year":"2014","journal-title":"Pediatrics"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/j.drugalcdep.2015.02.027","article-title":"Perinatal substance use: a prospective evaluation of abstinence and relapse","volume":"150","author":"A Forray","year":"2015","journal-title":"Drug Alcohol Depend"},{"issue":"02","key":"ref6","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1097\/00004703-199804000-00005","article-title":"The neonatal withdrawal inventory: a simplified score of newborn withdrawal","volume":"19","author":"W Zahorodny","year":"1998","journal-title":"J Dev Behav Pediatr"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"1419","DOI":"10.15585\/mmwr.mm675152e1","article-title":"Drug and opioid-involved overdose deaths - United States, 2013-2017","volume":"67","author":"L Scholl","year":"2018","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"05","key":"ref9","doi-asserted-by":"crossref","first-page":"997","DOI":"10.1097\/AOG.0000000000000208","article-title":"Increase in prescription opioid use during pregnancy among Medicaid-enrolled women","volume":"123","author":"R J Desai","year":"2014","journal-title":"Obstet Gynecol"},{"issue":"06","key":"ref10","doi-asserted-by":"crossref","first-page":"1131","DOI":"10.1097\/AOG.0000000000003279","article-title":"Pregnancy-associated death in Utah: contribution of drug-induced deaths","volume":"133","author":"M C Smid","year":"2019","journal-title":"Obstet Gynecol"},{"issue":"08","key":"ref11","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1038\/jp.2015.36","article-title":"Increasing incidence and geographic distribution of neonatal abstinence syndrome: United States 2009 to 2012","volume":"35","author":"S W Patrick","year":"2015","journal-title":"J Perinatol"},{"issue":"11","key":"ref12","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1038\/jp.2014.114","article-title":"Variation in treatment of neonatal abstinence syndrome in US children's hospitals, 2004-2011","volume":"34","author":"S W Patrick","year":"2014","journal-title":"J Perinatol"},{"issue":"18","key":"ref13","doi-asserted-by":"crossref","first-page":"1934","DOI":"10.1001\/jama.2012.3951","article-title":"Neonatal abstinence syndrome and associated health care expenditures: United States, 2000-2009","volume":"307","author":"S W Patrick","year":"2012","journal-title":"JAMA"},{"issue":"22","key":"ref14","doi-asserted-by":"crossref","first-page":"2118","DOI":"10.1056\/NEJMsa1500439","article-title":"Increasing incidence of the neonatal abstinence syndrome in U.S. neonatal ICUs","volume":"372","author":"V N Tolia","year":"2015","journal-title":"N Engl J Med"},{"issue":"02","key":"ref15","doi-asserted-by":"crossref","first-page":"e527","DOI":"10.1542\/peds.2013-4036","article-title":"A multicenter cohort study of treatments and hospital outcomes in neonatal abstinence syndrome","volume":"134","author":"E S Hall","year":"2014","journal-title":"Pediatrics"},{"issue":"31","key":"ref16","doi-asserted-by":"crossref","first-page":"799","DOI":"10.15585\/mmwr.mm6531a2","article-title":"Incidence of neonatal abstinence syndrome - 28 states, 1999-2013","volume":"65","author":"J Y Ko","year":"2016","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"08","key":"ref17","doi-asserted-by":"crossref","first-page":"1114","DOI":"10.1038\/s41372-018-0109-8","article-title":"Quality improvement initiative to improve inpatient outcomes for neonatal abstinence syndrome","volume":"38","author":"E M Wachman","year":"2018","journal-title":"J Perinatol"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.drugalcdep.2018.07.024","article-title":"Impact of psychiatric medication co-exposure on neonatal abstinence syndrome severity","volume":"192","author":"E M Wachman","year":"2018","journal-title":"Drug Alcohol Depend"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"j3326","DOI":"10.1136\/bmj.j3326","article-title":"Risk of neonatal drug withdrawal after intrauterine co-exposure to opioids and psychotropic medications: cohort study","volume":"358","author":"K F Huybrechts","year":"2017","journal-title":"BMJ"},{"issue":"08","key":"ref20","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1542\/hpeds.2018-0227","article-title":"Increased severity of neonatal abstinence syndrome associated with concomitant antenatal opioid and benzodiazepine exposure","volume":"9","author":"L A Sanlorenzo","year":"2019","journal-title":"Hosp Pediatr"}],"container-title":["American Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0040-1716490.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,2,26]],"date-time":"2022-02-26T00:52:09Z","timestamp":1645836729000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0040-1716490"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,6]]},"references-count":19,"journal-issue":{"issue":"04","published-online":{"date-parts":[[2022,2,25]]},"published-print":{"date-parts":[[2022,3]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0040-1716490","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"value":"0735-1631","type":"print"},{"value":"1098-8785","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9,6]]}}}