Health Collaborative to Look at Best Practices for Neonatal Abstinence Syndrome

The state’s maternal and child health leadersare working together to address the rising number of infants born with neonatal abstinence syndrome, the condition caused by exposure to narcotics during pregnancy. The initiative, the Kentucky Perinatal Quality Collaborative, brings together representatives from the Kentucky Department for Public Health, Kentucky Perinatal Association and the March of Dimes, among others.

“This is an extremely important public health issue and one that deserves our attention. If we, as policymakers and health care professionals, are serious about improving the collective health of our state, we must be committed to ensuring our most vulnerable citizens – Kentucky’s infants – are getting the healthiest start to life possible,” said Stephanie Mayfield, M.D., commissioner of the Kentucky Department for Public Health. “We must begin the discussion of substance abuse prevalence and the rise in substance exposed newborns and continue down the path to solving this problem.”

The number of babies exposed to drugs during pregnancy and undergoing withdrawal as a newborn – Neonatal Abstinence Syndrome or NAS – has dramatically increased during the last decade. In the year 2000, fewer than 30 infants were diagnosed with NAS in Kentucky. For the year 2013, that number was more than 950, according to DPH.

“The time has come to treat Neonatal Abstinence Syndrome like the true national public health emergency it is,” said Eric Reynolds, M.D., president of the Kentucky Perinatal Association (KPA). “In addition to the acute withdrawal syndrome as a newborn, infants affected by NAS are at increased risk for SIDS, abusive head trauma, attention and behavioral problems at school age, and their own addictive behaviors as adults.”

Just as the number of infants hospitalized with NAS has increased, the cost of care for the babies has grown exponentially. It was estimated that $190 million was spent nationally on patients with NAS in the year 2000. More recent data from 2009 suggests that the amount had increased to more than$720 million nationally. In Kentucky, figures from 2012 show that health care expenditures attributable to NAS were an estimated $40 million.

The Kentucky Perinatal Quality Collaborative was introduced earlier this month at the KPA annual meeting at Lake Cumberland State Park with the goal of collecting information from partnering hospitals in Kentucky. From there, information on best practices for treating infants with NAS will be disseminated to hospitals and maternal-infant health care providers.

The results of data collected will provide information toward standardized treatments to improve the outcomes of both the mothers and children affected by NAS. Initially, the focus will be on interventions for hospitalized newborns with NAS, including both medication and non-medical treatments.

“We recognize that the treatment of the infant is just the beginning of this process. Ideally, we need to devise policies and interventions to assist the mother, before and after birth, aimed at reducing substance abuse and eliminating NAS in Kentucky,” said Scott Duncan, M.D., a neonatologist and board member of the Kentucky Perinatal Association. “This is not a problem that will go away overnight.”

Kentucky Gov. Steve Beshear has made improving the health and wellness of Kentucky’s children, families and workforce one of his highest priorities. To significantly advance the wellbeing of Kentucky’s citizens, Gov. Beshear launched kyhealthnow in February as an aggressive and wide-ranging initiative to reduce incidents and deaths from Kentucky’s dismal health rankings and habits. It builds on Kentucky’s successful implementation of health care reform and uses multiple strategies over the next several years to improve the state’s collective health.

Addressing substance abuse is chief among the program’s list of goals, which target a 25 percent reduction in the number of deaths attributed to drug overdose.

“Substance abuse, particularly prescription drug abuse, is an epidemic in the Commonwealth and far too many Kentuckians have been affected by addiction,” said Health and Family Services Secretary Audrey Tayse Haynes. “As the perinatal quality collaborative makes clear, this is a problem that not only affects the health of addicts ky,but is also damaging the lives Kentucky’s infants.”

Additional information about the perinatal quality collaborative can be obtained through the Kentucky Perinatal Association at www.kentuckyperinatal.com.