Neonatal abstinence syndrome diagnosis is predictive of maternal mortality

  • Guttmann A & al.
  • PLoS Med
  • 01.11.2019

  • von Elisabeth Aron, MD, MPH, FACOG
  • Clinical Essentials
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Takeaway

  • Neonatal abstinence syndrome (NAS) may predict long-term maternal mortality.

Why this matters

  • Opioid use among pregnant women has been rising and increases risks for NAS in newborns.
  • The peripartum period is an opportunity to improve maternal health.
  • Ongoing support of mothers with opioid use disorder may prevent increased risk for maternal mortality.

Key results

  • Mothers with infants born with NAS had higher mortality rates (11-12 times) compared with controls.
  • The majority of deaths were from preventable causes such as intentional and unintentional injuries.
  • This difference persisted over time.

Study design

  • Population-based parallel-cohort study.
  • Administrative health data were used to develop parallel cohorts of mother-infant dyads in England and Ontario between 2002 and 2012.
  • Dyads with NAS (n=18,543) were compared with controls (n=5,149,237).
  • Primary exposure was a live birth of an infant with NAS.
  • Main outcome was all deaths among mothers following their delivery date.
  • Funding: Ontario Ministry of Health and Long-Term Care, National Institute for Health Research Policy Research Programme, Administrative Data Research Centre for England, Farr Institute of Health Informatics Research London, Medical Research Council; others.

Limitations

  • Potential linkage errors.
  • Misclassification of mothers using opioids whose babies did not develop NAS.