CDC Grand Rounds: Public Health Strategies to Prevent Neonatal Abstinence Syndrome

Ko, Jean Y.; Wolicki, Sara Beth; Barfield, Wanda D.; Patrick, Stephen W.; Broussard, Cheryl S.; Yonkers, Kimberly A.; Naimon, Rebecca; Iskander, John K.

doi:10.15585/mmwr.mm6609a2

Cited by 75 publications

(51 citation statements)

References 15 publications

(26 reference statements)

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“…In some states, >30 infants per 1000 live births develop NAS, effectively transforming some NICUs into NAS wards. 3 Although NAS can be a challenging condition to manage and requires intense investment of human resources, acute signs of withdrawal are transient and ultimately resolve. More important than how to manage NAS are these 2 questions: What are the best methods to prevent NAS?…”

mentioning

confidence: 99%

Fetal Opioid Exposure and Smaller Birth Head Circumference: Cause for Concern?

Hudak

Makker

2019

Pediatrics

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confidence: 99%

Fetal Opioid Exposure and Smaller Birth Head Circumference: Cause for Concern?

Hudak

Makker

2019

Pediatrics

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“…37 Infants prenatally exposed to opioids, including infants diagnosed with NAS Prenatal exposure to opioids can lead to adverse infant outcomes, including NAS. [38][39][40] NAS is often attributed to opioid withdrawal symptoms, but can occur from other drugs. Neonatal Opioid Withdrawal Syndrome (NOWS), a specific term to describe NAS due to opioid exposure, is an anticipated outcome for 40%-60% of infants who are born to mothers receiving MAT.…”

Section: Oud Among Postpartum Womenmentioning

confidence: 99%

Implementing a Learning Collaborative Framework for States Working to Improve Outcomes for Vulnerable Populations: The Opioid Use Disorder, Maternal Outcomes, and Neonatal Abstinence Syndrome Initiative Learning Community

Kroelinger

Addison

Rodriguez

et al. 2020

Journal of Women's Health

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The opioid crisis has impacted vulnerable populations, specifically pregnant and postpartum women, and infants prenatally exposed to substances, including infants with Neonatal Abstinence Syndrome. Lack of access to clinical and social services; potential stigma or discrimination; and lack of resources for provision of services, including screening and treatment, have impacted the health of these populations. In 2018, using a systems change approach, the Association of State and Territorial Health Officials (ASTHO) and the Centers for Disease Control and Prevention (CDC) convened an Opioid use disorder, Maternal outcomes, Neonatal abstinence syndrome Initiative Learning Community (OMNI LC) that included other federal agencies, national clinical and nonclinical organizations, and 12 state leadership groups. The purpose of the OMNI LC was to determine areas of focus and identify strategies and best practices for implementing systems change to improve maternal and infant outcomes associated with opioid use disorder (OUD) during the perinatal period. Activities included inperson convenings with policy goal action plan development, virtual learning sessions, intensive technical assistance (TA), and temporary field placements. The OMNI LC partnering agencies and state teams met bimonthly for the first year of the initiative. At the in-person convening, state teams identified barriers to developing and implementing systems change in activity-specific action plans within five areas of focus: financing and coverage; access to and coordination of quality services; provider training and awareness; ethical, legal, and social considerations; and data, monitoring, and evaluation. State teams also identified stakeholder partnerships as a necessary component of strategy development in all areas of focus. Four virtual learning sessions were conducted on the areas of focus identified by state teams, and ASTHO conducted three intensive TA opportunities, and five states were identified for temporary field placement. To successfully address the impact of the opioid crisis on pregnant and postpartum women and infants, states developed innovative strategies focused on increasing support, services, and resources. Moving forward, state teams will participate in two additional in-person meetings, continue to identify barriers to the work, refine and customize action plans, and set new goals, to effect broad-ranging systems change for these vulnerable populations.

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“…© 2020 Society of Hospital Medicine EPIDEMIOLOGY Although the opioid crisis and resulting rise in NAS have affected communities across the US, substantial statewide variation exists, with extremes ranging from 0.7 per 1,000 births affected by NAS in Hawaii to 33.4 per 1,000 births in West Virginia. 12 Within states, increased maternal OUD and NAS rates have also disproportionately affected rural communities possibly due to reduced access to healthcare and mental health services and poor economic conditions. 13 A recent national study demonstrated that the proportion of newborns with NAS who were born in rural hospitals increased from 12.9% to 21.2% over the past decade; these rural newborns with NAS are more likely to be publicly insured and to require transfer after birth than newborns in urban hospitals.…”

Section: Definitionmentioning

confidence: 99%

Hospital Care of Opioid‐Exposed Newborns: Clinical and Psychosocial Challenges

Goyal

McAllister

2020

Journal of Hospital Medicine

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In the past two decades, the incidence of neonatal abstinence syndrome (NAS) has risen fivefold, mirroring the rise of opioid use disorder (OUD) among pregnant women. The resulting increases in length of stay and neonatal intensive care utilization are associated with higher hospital costs, particularly among Medicaid-financed deliveries. Pregnant women with OUD require comprehensive medical and psychosocial evaluation and management; this combined with medication-assisted treatment is critical to optimize maternal and newborn outcomes. Multidisciplinary collaboration and standardized approaches to screening for intrauterine opioid exposure, evaluation and treatment of NAS, and discharge planning are important for clinical outcomes and may improve maternal experience of care.

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CDC Grand Rounds: Public Health Strategies to Prevent Neonatal Abstinence Syndrome

Cited by 75 publications

References 15 publications

Fetal Opioid Exposure and Smaller Birth Head Circumference: Cause for Concern?

Fetal Opioid Exposure and Smaller Birth Head Circumference: Cause for Concern?

Implementing a Learning Collaborative Framework for States Working to Improve Outcomes for Vulnerable Populations: The Opioid Use Disorder, Maternal Outcomes, and Neonatal Abstinence Syndrome Initiative Learning Community

Hospital Care of Opioid‐Exposed Newborns: Clinical and Psychosocial Challenges

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