Table 4:
Estimated effects of any opioid exposure during pregnancy on infant health and wellbeing, by type of exposure
| Fraction of pregnancy exposed | Exposure indicator | |||||
|---|---|---|---|---|---|---|
|
|
||||||
| Full | Sibling | Sibling | Full | Sibling | Sibling | |
|
| ||||||
| Narrow NAS | ||||||
| MAT | 0.676*** | 0.652*** | 0.517*** | 0.546*** | 0.535*** | 0.376*** |
| SE | (0.013) | (0.016) | (0.025) | (0.014) | (0.018) | (0.024) |
| % mean DV | 422.5% | 138.7% | 110.0% | 341.3% | 113.8% | 80.0% |
| non-MAT | 0.248*** | 0.229*** | 0.151*** | 0.015*** | 0.007*** | 0.002 |
| SE | (0.012) | (0.017) | (0.022) | (0.001) | (0.002) | (0.001) |
| % mean DV | 155.0% | 48.7% | 32.1% | 9.4% | 1.5% | 0.4% |
| Illicit | 0.656*** | 0.620*** | 0.442*** | 0.079*** | 0.054** | 0.054** |
| SE | (0.020) | (0.027) | (0.033) | (0.017) | (0.022) | (0.025) |
| % mean DV | 410.0% | 131.9% | 94.0% | 49.4% | 11.5% | 11.5% |
| Broad NAS | ||||||
| MAT | 0.821*** | 0.788*** | 0.594*** | 0.673*** | 0.661*** | 0.447*** |
| SE | (0.010) | (0.013) | (0.023) | (0.012) | (0.016) | (0.023) |
| % mean DV | 241.5% | 98.5% | 74.3% | 197.9% | 82.6% | 55.9% |
| non-MAT | 0.374*** | 0.344*** | 0.249*** | 0.028*** | 0.012*** | 0.003 |
| SE | (0.014) | (0.020) | (0.024) | (0.001) | (0.002) | (0.002) |
| % mean DV | 110.0% | 43.0% | 31.1% | 8.2% | 1.5% | 0.4% |
| Illicit | 0.779*** | 0.748*** | 0.535*** | 0.080*** | 0.053*** | 0.054** |
| SE | (0.017) | (0.023) | (0.031) | (0.015) | (0.019) | (0.024) |
| % mean DV | 229.1% | 93.5% | 66.9% | 23.5% | 6.6% | 6.8% |
| Low birthweight | ||||||
| MAT | 0.124*** | 0.111*** | 0.060*** | 0.117*** | 0.104*** | 0.052*** |
| SE | (0.010) | (0.014) | (0.018) | (0.011) | (0.014) | (0.018) |
| % mean DV | 14.1% | 9.8% | 5.3% | 13.3% | 9.2% | 4.6% |
| non-MAT | 0.128*** | 0.097*** | 0.046** | 0.015*** | −0.004 | −0.009** |
| SE | (0.011) | (0.015) | (0.019) | (0.002) | (0.003) | (0.003) |
| % mean DV | 14.5% | 8.6% | 4.1% | 1.7% | −0.4% | −0.8% |
| Illicit | 0.110*** | 0.107*** | 0.051** | −0.008 | −0.011 | −0.016 |
| SE | (0.016) | (0.022) | (0.024) | (0.013) | (0.016) | (0.018) |
| % mean DV | 12.5% | 9.5% | 4.5% | −0.9% | −1.0% | −1.4% |
| Preterm | ||||||
| MAT | 0.071*** | 0.070*** | 0.036* | 0.072*** | 0.065*** | 0.029* |
| SE | (0.010) | (0.013) | (0.019) | (0.010) | (0.013) | (0.017) |
| % mean DV | 6.8% | 5.3% | 2.7% | 6.9% | 4.9% | 2.2% |
| non-MAT | 0.112*** | 0.073*** | 0.018 | 0.017*** | −0.007** | −0.012** |
| SE | (0.011) | (0.015) | (0.022) | (0.002) | (0.003) | (0.003) |
| % mean DV | 10.7% | 5.5% | 1.4% | 1.6% | −0.5% | −0.9% |
| Illicit | 0.081*** | 0.067*** | −0.001 | −0.003 | −0.009 | −0.019 |
| SE | (0.016) | (0.021) | (0.023) | (0.012) | (0.015) | (0.018) |
| % mean DV | 7.7% | 5.1% | −0.1% | −0.3% | −0.7% | −1.4% |
| Small for gestational age | ||||||
| MAT | 0.156*** | 0.130*** | 0.068*** | 0.137*** | 0.122*** | 0.057*** |
| SE | (0.011) | (0.015) | (0.022) | (0.012) | (0.015) | (0.020) |
| % mean DV | 13.0% | 9.6% | 5.0% | 11.4% | 9.0% | 4.2% |
| non-MAT | 0.100*** | 0.080*** | 0.038* | 0.014*** | 0.005 | 0.002 |
| SE | (0.011) | (0.016) | (0.022) | (0.002) | (0.003) | (0.003) |
| % mean DV | 8.3% | 5.9% | 2.8% | 1.2% | 0.4% | 0.1% |
| Illicit | 0.119*** | 0.108*** | 0.080*** | −0.007 | −0.012 | 0.005 |
| SE | (0.018) | (0.023) | (0.028) | (0.014) | (0.018) | (0.021) |
| % mean DV | 9.9% | 7.9% | 5.9% | −0.6% | −0.9% | 0.4% |
| APGAR < 7 | ||||||
| MAT | 0.010** | 0.006 | 0.016* | 0.024*** | 0.015** | 0.010 |
| SE | (0.005) | (0.006) | (0.009) | (0.006) | (0.007) | (0.011) |
| % mean DV | 4.0% | 2.4% | 6.4% | 9.6% | 6.0% | 4.0% |
| non-MAT | 0.015*** | 0.006 | −0.005 | 0.003*** | −0.002 | −0.003* |
| SE | (0.005) | (0.006) | (0.011) | (0.001) | (0.002) | (0.002) |
| % mean DV | 6.0% | 2.4% | −2.0% | 1.2% | −0.8% | −1.2% |
| Illicit | 0.007 | 0.016 | 0.010 | −0.020** | −0.009 | −0.001 |
| SE | (0.008) | (0.011) | (0.015) | (0.006) | (0.008) | (0.011) |
| % mean DV | 2.8% | 6.4% | 4.0% | −8.0% | −3.6% | −0.4% |
| CPS in 7 days | ||||||
| MAT | 0.115*** | 0.113*** | 0.072*** | 0.105*** | 0.103*** | 0.061*** |
| SE | (0.009) | (0.012) | (0.019) | (0.009) | (0.012) | (0.018) |
| % mean DV | 82.1% | 37.7% | 24.0% | 75.0% | 34.3% | 20.3% |
| non-MAT | 0.069*** | 0.057*** | 0.017 | 0.007*** | −0.002 | −0.003** |
| SE | (0.007) | (0.011) | (0.016) | (0.001) | (0.002) | (0.002) |
| % mean DV | 49.3% | 19.0% | 5.7% | 5.0% | −0.7% | −1.0% |
| Illicit | 0.251*** | 0.244*** | 0.092*** | 0.064*** | 0.056*** | 0.011 |
| SE | (0.018) | (0.024) | (0.030) | (0.012) | (0.016) | (0.019) |
| % mean DV | 179.3% | 81.3% | 30.7% | 45.7% | 18.7% | 3.7% |
|
| ||||||
| N | 255,227 | 44,838 | 44,838 | 256,755 | 45,161 | 45,161 |
|
| ||||||
| NICU Admission | ||||||
| MAT | 0.347*** | 0.334*** | 0.211*** | 0.307*** | 0.294*** | 0.183*** |
| SE | (0.014) | (0.018) | (0.026) | (0.014) | (0.018) | (0.026) |
| % mean DV | 35.4% | 26.7% | 16.9% | 31.3% | 23.5% | 14.6% |
| non-MAT | 0.197*** | 0.167*** | 0.062** | 0.021*** | −0.000 | −0.011** |
| SE | (0.013) | (0.018) | (0.027) | (0.002) | (0.003) | (0.003) |
| % mean DV | 20.1% | 13.4% | 5.0% | 2.1% | 0.0% | −0.9% |
| Illicit | 0.360*** | 0.357*** | 0.238*** | 0.015 | 0.014 | 0.006 |
| SE | (0.021) | (0.028) | (0.036) | (0.017) | (0.022) | (0.026) |
| % mean DV | 36.7% | 28.6% | 19.0% | 1.5% | 1.1% | 0.5% |
|
| ||||||
| N | 227,053 | 39,575 | 39,575 | 228,352 | 39,854 | 39,854 |
|
| ||||||
| Year FE | YES | YES | YES | YES | YES | YES |
| MFE | NO | NO | YES | NO | NO | YES |
Note: Data are from the 2010 –2019 birth cohorts in Wisconsin’s BD4LK linked administrative data. See caption on Table 1 for data details and Table 2 for measure definitions. Outcomes include Narrow and broad definitions of neonatal abstinence syndrome (NAS), child protective services (CPS) report in the first seven days following birth, measured using administrative CPS records, admission to the neonatal intensive care unit (NICU) measured using Medicaid claims (available after 2010), having a low birthweight (LBW) diagnosis (< 2,500g), having a preterm diagnosis (born before 37 weeks), having a small-for-gestational age (SGA) diagnosis (<10th percentile for weight-for-age), and having a five-minute APGAR score of less than 7. Full sample includes all mothers and infants, whereas sibling sample includes only mothers with more than one infant. All models include controls for maternal and child characteristics, including race/ethnicity (White NH, Black NH, Hispanic, and other), maternal age at the start of pregnancy (< 22, 22–30, 31+), education (less than HS, HS or higher), marital status at delivery (married or single), birth order, infant sex (male, female), an indicator for plurality, birth quarter, county urbanicity (urban/rural). In models in which we measure daily opioid exposure, we further include a measure of gestational age using the obstetric estimate. Year fixed effects indicate the infant’s year of birth. Standard errors are clustered at the level of the mother.
p < 0.1
p < 0.05
p < 0.01