Long-Term Developmental Outcomes of Infants With Neonatal Abstinence Syndrome [ID: 1375900

Abstract

INTRODUCTION: There is limited information on long-term developmental outcomes in infants with neonatal abstinence syndrome (NAS). We evaluated the infant outcomes of women with opioid use disorder based on newborn pharmacologic treatment of NAS after birth. METHODS: This retrospective cohort study identified opioid-exposed gestations presenting for delivery from January 2017 to July 2022. Infants were included if follow-up data was available and were divided based on pharmacologic treatment of NAS. Pregnancy information, newborn demographics, and infant care up to 4 years of age were collected. Assessments of infant outcomes included standardized developmental milestones along with any developmental delays. Statistical analysis included chi-square and Student t tests with significance levels of P<.05. RESULTS: There were 387 infants with 170 (44%) requiring pharmacologic treatment of NAS and 217 (56%) not requiring treatment. The gestational age at delivery, mode of delivery, birth weight, and rate of Plan of Safe Care (POSC) on discharge were similar between groups. Newborns receiving pharmacologic treatment were more likely to experience preterm birth (PTB) (22.4% versus 12.9%, P=.02), have a positive toxicology (83.4% versus 64.2%, P=.001), and a longer median length of stay with PTB removed (9.0 versus 7.0 days, P=.001). Developmental outcomes related to social-emotional delay, language-communication delay, cognitive delay, and physical-motor delay were similar between groups at 2–6 months (n=177), 9–18 months (n=138), and 2–4 years (n=94). CONCLUSION: Infants from opioid-exposed gestations that experienced NAS have similar long-term outcomes regardless of pharmacologic treatment for NAS after birth.