Neonatal abstinence syndrome (NAS) can be diagnosed in babies born with exposure to a variety of addictive substances, including opioids, amphetamines, and benzodiazepines. Because of the ongoing and worsening opioid epidemic1 and the established risk of NAS in babies born to parents taking prescribed opioids2, we studied more than 1.3 million births that occurred between January 1, 2018, and January 1, 2022, to examine the role of prescription opioids in babies born with NAS. For those births, we identified babies born with NAS and how many of those babies’ mothers were prescribed an opioid within 90 days before the birth.
Our data show that 86.1% of babies with NAS were born to pregnant mothers without such a prescription (Figure 1), suggesting that most NAS cases aren’t tied to opioid prescriptions. Therefore, clinicians should review patient drug use history to be aware of possible NAS in patients without an opioid prescription.
1.5% of pregnant mothers had an opioid prescription. Of those mothers who had an opioid prescription and whose babies had NAS, 76% of their opioid prescriptions were for buprenorphine, accounting for 10.5% of all babies who had NAS. Buprenorphine is often used to treat opioid use disorder. Clinicians should consider whether the potential risk of NAS from buprenorphine outweighs the risks of abstinence related to opioid use disorder during pregnancy.3,4
Original Publication Date: June 7, 2022
Last Updated: June 8, 2022
The title of this brief was updated to reflect a more accurate description of how babies experience neonatal withdrawal syndrome. See this article for more information.
