Short-term outcomes of infants of substance-using mothers admitted to neonatal intensive care units in New South Wales and the Australian Capital Territory

Authors

  • Mohamed E Abdel-Latif,

    1. Department of Newborn Care, Royal Hospital for Women, Randwick,
    2. School of Women’s and Children’s Heath, University of New South Wales, Kensington and
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  • Barbara Bajuk,

    1. Neonatal Intensive Care Units’ (NICUS) Data Collection, NSW Centre for Perinatal Health Services Research, Queen Elizabeth II Research Institute, University of Sydney, Sydney, New South Wales, Australia
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  • Kei Lui,

    Corresponding author
    1. Department of Newborn Care, Royal Hospital for Women, Randwick,
    2. School of Women’s and Children’s Heath, University of New South Wales, Kensington and
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  • Julee Oei,

    1. Department of Newborn Care, Royal Hospital for Women, Randwick,
    2. School of Women’s and Children’s Heath, University of New South Wales, Kensington and
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  • the NSW on ACT Neonatal Intensive Care Units’ Study (NICUS) Group

    1. Department of Newborn Care, Royal Hospital for Women, Randwick,
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Dr Kei Lui, Department of Newborn Care, Royal Hospital for Women, Barker Street, Randwick, NSW 2031, Australia. Fax: +61 2 9382 6191; email: kei.lui@sesiahs.health.nsw.gov.au

Abstract

Aim:  Illicit substance use during pregnancy is associated with an increased rate of perinatal complications. Our study examines if outcome of infants of substance-using mothers (ISMs) in the neonatal intensive care unit (NICU) setting is similar to unexposed infants (controls).

Methods:  A prospective state-wide NICU study comparing ISMs to control infants admitted to 10 NICUs during a 3-years period (2001–2003). An ISM was defined as an infant whose mother admitted to or was documented to have used substances of dependency (illicit or otherwise) during this pregnancy.

Results:  There was a preponderance towards prematurity with ISMs comprising 5.1% (n = 310) of 6120 high risk infants (6.2% (n = 165) <32 weeks gestation and 6.8% (n = 39) of 22–26 weeks gestation). More ISMs were outborn and had significantly lower mortality rate, particularly in the <32 week gestation subgroup (adjusted OR 0.517 95% CI 0.277–0.962, P < 0.037). ISMs also demonstrated a non-significant trend towards an increased risk of neonatal morbidities. The pattern of rural and urban substance use was different, with a higher incidence of opiate use (49.3% vs. 26.9%, P < 0.001) in urban areas. Most opiate using mothers (85.6%), irrespective of rural or urban residence, were enrolled in methadone programmes. ISMs had a higher incidence of antepartum haemorrhage and chorioamnionitis and fewer were given antenatal steroids.

Conclusion:  ISMs are common in the high-risk NICU population. Further studies are needed to confirm the lower mortality rate and long-term outcomes in these infants.

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