637 - Decreasing incidence of Neonatal Abstinence Syndrome in Infants of All Gestations

Publication Number: 4623.637

PRABHAKAR KOCHERLAKOTA, Maria Fareri Children's Hospital at Westchester Medical Center, Newburgh, NY, United States; Abigail E. Druffner, Montefiore St. Lukes Cornwall, Middletown, NY, United States

Background: Neonatal abstinence syndrome (NAS), also known as neonatal opioid withdrawal syndrome, is a major pediatric public health concern. NAS is associated with significant morbidity, prolonged hospital stays, and adverse neurodevelopmental outcomes. In the past decade, measures like cutting prescription opioid use, physician monitoring programs, expanding MAT facilities, and easing buprenorphine rules have aimed to reduce substance use during pregnancy. Whether these measures have led to a decrease in the incidence of NAS remains uncertain

Objective: To evaluate trends in the incidence of NAS among hospitalized infants among various gestations from 2016 to 2024.

Design/Methods: We conducted a retrospective chart review of all infants admitted to the NICU of our hospital with a diagnosis of NAS between 2016 and 2024. Infants were diagnosed with NAS if they exhibited three or more clinical signs and toxicology confirmed exposure. Maternal (age, parity, gestational age, delivery method) and neonatal (sex, birth weight, feeding, toxicology, treatment) data were obtained from electronic records. Incidence was measured as infants diagnosed with NAS divided by total NICU admissions. Statistical analyses were conducted with significance at p < 0.05. The study was approved by the institutional review board (IRB).

Results: Of 2,041 infants admitted (2016-2024), 180 had NAS; 163 were over 35 weeks and 140 were over 37 weeks gestation. Table 2 summarize neonatal characteristics. The incidence of NAS decreased from 11% to 5.5% in all gestations, from 10.5 to 4.5% in infants >35 weeks and from 8.5 to 4.5% from 2016 to 2024 (Table 3 and Figure 1)

Conclusion(s): There has been a significant decline in the incidence of NAS during the study period. This decrease was observed across all gestational age groups, suggesting that recent public health and clinical initiatives may be contributing to a reduction in prenatal substance exposure.

Table 2: Neonatal Demographic data


Table 2: Neonatal Demographic Data


Figure 1: The incidence of NAS in different gestations