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Neonatal Abstinence Syndrome

Neonatal Abstinence Syndrome (NAS) is a combination of signs and symptoms of in utero drug exposure. While it mostly occurs in the context of antepartum opiates, these symptoms may be attributed to a multitude of drug exposures (e.g., central nervous system stimulants or depressants). An important difference in neonates experiencing withdrawal after birth is that they are not addicted or psychologically dependent on drugs, rather they are manifesting physical signs and symptoms of withdrawal.  

Infants with NAS are more likely to have lengthy hospital stays and other complications including low birth weight, feeding difficulties, jaundice, respiratory distress syndrome, and seizures.  According to a recent analysis of Census Bureau data for 2012, Florida has a rate of approximately 7 NAS cases per 1,000 live births which is higher than the rate of 5.8 cases per 1,000 live births for the United States.  Also, NAS incidence increased 383%, 2000-2012, and it is estimated 80% of hospital charges for NAS are covered by state Medicaid programs.  Additionally, mean hospital charges for NAS increased from $39,000 in 2000 to $53,400 in 2009.  

A number of state-based perinatal quality collaboratives indicate efforts to address NAS on their websites. The evidence base on approaches and practices to addressing NAS is evolving. The FPQC is in the process of convening an expert advisor work group to plan a hospital-based initiative on NAS with the intention of recruiting hospitals in 2018.