The incidence of substance use disorders (SUD) in pregnant women and subsequent delivery of infants with neonatal abstinence syndrome have been increasing in recent
years. To date, epidemiologic studies about maternal SUD and infant outcomes have only been cross-sectional, lacking analysis of outcomes of individual mothers and infants longitudinally. Moreover, maternal and infant outcomes have been assessed as separate cohorts and not linked as mother-infant dyads. We propose to address these gaps through analysis of a longitudinal database that links maternal and infant medical records and allows for a more robust approach to identifying maternal SUD. This study will address the Maternal and Child Health Bureau Strategic Research Issue #IV: Promoting the healthy development of MCH populations.
Aims/Methods: We will determine the following: 1) the association of maternal SUD with
adverse neonatal outcomes (including neonatal abstinence syndrome, prolonged hospital stay, respiratory problems, feeding difficulties, and neurologic problems; 2) the association of
maternal SUD and infant hospital re-admissions, observational stays, and emergency room visits in the first year of life. We will analyze the following three linked statewide datasets from 2002-2010: 1) The Massachusetts Pregnancy to Early Life Longitudinal (PELL) Data System which longitudinally links birth certificates and fetal death records to their corresponding hospital discharge records for the delivery for mothers and infants; 2) The Center for Health Information and Analysis (CHIA) Case Mix database (non-birth/non-delivery-related hospital discharge, observational stay, and emergency department visit records); and 3) The Massachusetts Bureau of Substance Abuse Services (BSAS) Enterprise Invoice Management-Enterprise Service Management (EIMESM) dataset (treatment records for over 25,000 annual admissions of women of reproductive age to all publicly-funded substance abuse treatment facilities).
Significance: Given the linkage of maternal and infant hospital records along with further
linkage with maternal receipt of substance abuse treatment services data, the results of this study will be the most comprehensive description of infants born to mothers with SUD and subsequent medical complications of their infants. This study will also be the first to examine hospital readmissions, observational stays, and emergency care utilization by infants of mothers with SUD.