Abstract
<h3>Research Objectives</h3> Medical rehabilitation for neonatal abstinence syndrome (NAS) combines medically supervised opiate weaning with intensive, individualized therapeutic supports. The purpose of this study is to investigate differences in length of stay in an NAS treatment program by: 1) early admission (by day 14 of life versus after); and 2) infant characteristics including prenatal narcotic exposure, prenatal care, birth complications, and demographics. <h3>Design</h3> Secondary analysis of data abstracted from electronic medical records. <h3>Setting</h3> An acute inpatient pediatric rehabilitation facility in the Northeast with a dedicated NAS program. <h3>Participants</h3> 62 infants were admitted for NAS treatment between July 2016 and April 2020. One case was excluded because of an atypical length of stay. The final analytic sample was N=61. <h3>Interventions</h3> Not applicable. <h3>Main Outcome Measures</h3> Inpatient rehabilitation length of stay in days. <h3>Results</h3> Infants with NAS in this sample spent an average of 17.9 days in the NICU, with a range of 5 to 39 days. 38% were admitted for NAS rehabilitation within two weeks of birth. These infants spent significantly less time in acute rehabilitation compared to infants admitted for NAS treatment after day 14 of life. Based on the results of a Poisson regression model, the predicted length of stay was 15.2 days (95% CI: 13.6-16.8) for infants in the early admission group and 19.9 days (95% CI: 18.5-21.4) for the later admission group, adjusting for differences in prenatal narcotic exposures, delivery type, birth complications, sex, and race. <h3>Conclusions</h3> Early admission for NAS reduces the length of time required to wean infants from opiates. We discuss the benefits of improving the referral process between NICU and NAS medical rehabilitation programs for this vulnerable population. <h3>Author(s) Disclosures</h3> None.
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