Researchers from the University of Michigan and Vanderbilt University tracked cases of newborns exposed to opioids in the womb and experienced withdrawal symptoms after birth – known as neonatal abstinence syndrome – which can lead to seizures, low birth weight and sleeping and breathing problems.
Their findings, published Monday in the journal JAMA Pediatrics, highlight the rise in opioid-related complications among rural pregnant women and their infants, as newborns diagnosed with neonatal abstinence syndrome increased from nearly one case per 1,000 births in 2003-2004 to 7.5 cases in 2012-2013.
“The opioid epidemic has hit rural communities especially hard and we found that these geographical disparities also affect pregnant women and infants,” said lead author Nicole Villapiano, a pediatrician at the University of Michigan C.S. Mott Children’s Hospital. “If we can provide resources to the areas that need them the most, we can do more on the front lines to address the opioid crisis for our most vulnerable patients.”
National trends in maternal opioid use reflect geographical differences, as rural infants accounted for 21 percent of all infants born with neonatal abstinence syndrome between 2012 and 2013 – a surge from 2003, when rural newborns made up only 13 percent of cases in the United States.
Rural mothers and infants affected by opioids tend to be from lower-income families, which have public insurance and lack access to treatment facilities. On the other hand, families in urban areas typically have greater access to care and better outcomes.
“Our study highlights an urgent need to fund providers and programs that will help improve access to opioid prevention and treatment services for rural women and children,” Villapiano said.
Opioid addiction is a growing health crisis in the United States, as pharmaceutical drugs like Vicodin and Opana – which have similar properties to heroin – are being abused and over-prescribed.
Treating pregnant women who abuse opioids with drugs like buprenorphine, combined with an addiction treatment program, produces better outcomes when compared to patients without access to such services. Villapiano says that authorizing more rural doctors to prescribe such drugs and expanding rural substance abuse programs and mental health services are good first steps toward helping rural families overcome opioid addiction.
“We need to consider what kind of support moms with opioid disorders have in rural communities,” she said.
Stephen Patrick, a health policy professor at Vanderbilt University and senior author of the study, said that hospitals in rural communities must also be properly staffed and funded to treat babies born with opioid withdrawals.
“We need to develop means to support rural hospitals, especially critical access hospitals, that are on the front lines in providing care for mothers and infants impacted by the opioid epidemic,” he said.