Each year, an alarming number of babies born in the United States spend their first few days withdrawing from drugs, often prescription painkillers their mothers took during their pregnancies. This problem, called neonatal abstinence syndrome (NAS), has increased fourfold since 2004, according to a report published online yesterday in The New England Journal of Medicine.
NAS occurs in many babies whose mothers took a type of medication called an opioid during pregnancy. (Two commonly used opioids are OxyContin and Vicodin.) These drugs easily pass from the mother’s bloodstream to the baby’s. They can be addictive, and are often abused. In effect, NAS is a baby’s withdrawal from opioids.
Babies with NAS are stiffer and more irritable than normal babies. They don’t feed well, and so don’t gain weight well. Some have seizures. With medication and time, babies with NAS get better, but they have to spend time in the hospital. In short, they get a rough start on life that can set them back and possibly have long-term repercussions.
For the new study, researchers from several U.S. medical centers looked at the records of almost 700,000 newborns treated in 299 neonatal intensive care units around the country between 2004 and 2013. During that period, the number of children treated for NAS rose nearly fourfold, from 7 cases per 1,000 babies admitted to neonatal intensive care units to 27 cases per 1,000. Neonatal intensive care unit days needed to treat babies with NAS went up sevenfold. The report was published yesterday to coincide with a presentation of the results at the Pediatric Academic Societies annual meeting in San Diego.
In the study, the leading cause of NAS was mothers taking methadone during pregnancy, which accounted for nearly one-third of cases. Methadone is a medication used to treat drug addiction, especially heroin addiction. The second most common reason for NAS was mothers taking opioid painkillers.
Safer pain options
The number of prescriptions for opioid painkillers has skyrocketed in recent years, as has the number of people addicted to opioids. Some prescriptions for opioids are written for pregnant women. A survey published online in Pediatrics found that 28% of pregnant women with Medicaid in Tennessee received at least one prescription for an opioid pain reliever during their pregnancies.
With so many safe options for pain control, women who are pregnant should use opioids only if these medications are absolutely necessary. Doctors can often recommend other effective options for pain control that are safer for the baby.
Because opioids are so addictive, many people become dependent on them. Pregnant women are no different — some are addicted before they become pregnant, others become addicted during pregnancy. In either case, the health of the baby is at stake.
With opioid addiction on the rise, it’s likely that the number of babies with NAS will continue to climb, too. It’s often difficult for someone in the grip of addiction to make a healthy change. That’s why it’s important that the partners, family members, and friends of pregnant women be aware of this problem. Sometimes they are the best ones to speak up, give support, and make a difference. Studies like this one that draw attention to the youngest, most vulnerable, and totally innocent victims of opioids may also help galvanize us to fight opioid addiction once and for all.