Abstract
Objectives
To propose a measure for adverse maternal experiences (AMEs) and examine if AMEs are independently associated with delivery of a neonatal abstinence syndrome (NAS) diagnosed infant.
Methods
Using the Pregnancy Risk Assessment Monitoring System (PRAMS) stressful life events questions, we constructed a composite measure of AMEs. We conducted a retrospective analysis of linked Birth Certificate Data, Hospital Discharge Data and PRAMS data for 2012–2018 using the composite measure. Our analytic sample included 6358 singleton deliveries. We calculated prevalence of NAS and AMEs and prevalence odds ratio (POR) for delivery of an NAS-diagnosed infant adjusting for maternal sociodemographic characteristics, pre-pregnancy depression, prescription medicine 12 months prior to pregnancy, and smoking during pregnancy.
Results
The overall prevalence of NAS in Delaware during 2012–2018 was 2.2% (95% CI 1.8–2.6); 9.5% (95% CI 8.7–10.2) of women reported AMEs. After adjustment, women with AMEs had 1.1 times greater odds (aPOR 2.1; 95% CI 1.3–3.3) to deliver a NAS-diagnosed infant as compared with women without AMEs.
Conclusions
Although the cross-sectional nature of the study limits drawing any causal inferences, there are co-occurring factors that support plausibility of an association between AMEs and delivering NAS-diagnosed infants. Addressing AMEs, mental health and substance use screening and treatment as part of preconception and prenatal care may mitigate risks.
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Funding
PRAMS is made possible with assistance from CDC grant 5U01DP006239. The data linkage activity is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) Grant H18MC000 under the State Systems Development Initiative (SSDI).
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KSH: Conceptualization, Methodology, Software, Formal analysis, Writing—Original Draft, GY: Conceptualization, Writing—Reviewing and Editing. Our study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guideline.
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The study involved no human participants, and the use of secondary data was reviewed, and the activity was determined to meet the requirements of public health surveillance by the Delaware Division of Public Health under applicable federal law.
Disclaimer The findings and conclusions in this study are those of the authors and do not necessarily represent the official position of the U.S. Department of Health and Human Services, the Centers for Disease Control and Prevention, the Health Resources and Services Administration, or the Delaware Department of Health Social Services, Division of Public Health.
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Hussaini, K.S., Yocher, G. Adverse Maternal Experiences and Neonatal Abstinence Syndrome. Matern Child Health J 27, 497–507 (2023). https://doi.org/10.1007/s10995-022-03577-1
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DOI: https://doi.org/10.1007/s10995-022-03577-1