Table 2.
Maternal demographics, birth parameters, and county social determinants of health in association with NAS in Pennsylvania, 2018–2019
| NAS | ||
|---|---|---|
| Characteristic | OR (95% CI) | AORa (95% CI) |
| Maternal age | ||
| ≤ 24 | REF | REF |
| 25–29 | 2.2 (1.9, 2.4) | 3.0 (2.7, 3.4) |
| 30–34 | 2.1 (1.9, 2.3) | 4.4 (3.9, 5.0) |
| ≥ 35 | 1.7 (1.5, 1.9) | 3.7 (3.3, 4.3) |
| Maternal race/ethnicity | ||
| Non-Hispanic Asian or Pacific Islander | 0.5 (0.4, 0.7) | 1.0 (0.7, 1.2) |
| Non-Hispanic Black | REF | REF |
| Hispanic | 0.7 (0.6, 0.9) | 0.9 (0.7, 1.1) |
| Non-Hispanic White | 2.5 (2.2, 2.9) | 6.0 (5.2, 7.0) |
| Maternal education | ||
| High school or below | REF | REF |
| Some college | 0.7 (0.6, 0.7) | 0.7 (0.7, 0.8) |
| Bachelors or above | 0.1 (0.1, 0.1) | 0.1 (0.1, 0.1) |
| Primary payor at delivery | ||
| Private insurance | REF | REF |
| Medicaid | 8.5 (7.7, 9.4) | 4.9 (4.4, 5.5) |
| Self-pay | 0.4 (0.3, 0.7) | 0.1 (0.1, 0.2) |
| Initiated prenatal care | ||
| No | 5.1 (4.4, 5.9) | 1.8 (1.6, 2.2) |
| Yes | REF | REF |
| Adequacy of Prenatal Care Utilization Index | ||
| Inadequate | 4.1 (3.7, 4.4) | 2.9 (2.6, 3.2) |
| Intermediate | 2.3 (2.1, 2.6) | 2.2 (2.0, 2.5) |
| Adequate or Adequate Plus | REF | REF |
| Any smoking during pregnancy | ||
| No | REF | REF |
| Yes | 6.0 (5.6, 6.5) | 3.3 (3.1, 3.6) |
| County median household income quartile b | ||
| 1 | 2.8 (1.7, 4.5) | 1.8 (1.0, 3.0) |
| 2 | 2.0 (1.3, 3.3) | 1.2 (0.7, 1.9) |
| 3 | 1.9 (1.2, 3.1) | 1.3 (0.9, 2.1) |
| 4 | REF | REF |
| Urban/rural designation for county of residence | ||
| Metropolitan | 1.1 (0.9, 1.4) | 1.2 (1.0, 1.5) |
| Non-metropolitan | REF | REF |
| Mental health HPSA designation in county of residence | ||
| None of the county designated | REF | REF |
| One or more parts of the county designated | 1.1 (0.6, 1.8) | 0.9 (0.5, 1.5) |
| The whole county designated | 1.7 (1.0, 2.9) | 0.8 (0.5, 1.5) |
| Primary care provider HPSA designation in county of residence | ||
| None of the county designated | REF | REF |
| One or more parts of the county designated | 1.3 (0.8, 2.3) | 1.2 (0.7, 2.2) |
| The whole county designated | 1.7 (0.3, 9.3) | 1.9 (0.5, 7.5) |
| Number of substance treatment facilities providing all three forms of MOUD c | 0.9 (0.8, 1.0) | 0.9 (0.4, 2.1) |
| Number of substance treatment facilities providing all three forms of MOUD that accept Medicaid c | 0.9 (0.8, 1.0) | 1.1 (0.4, 2.7) |
Note. NAS = Neonatal Abstinence Syndrome; AOR = adjusted odds ratio; CI = confidence interval; REF = referent group; HPSA = Health Professional Shortage Area, MOUD = Medication for opioid use disorder
a Adjusted for all covariates listed and with random intercept included to control for clustering by maternal county of residence
b Median household income by county in quartile 1 is ≤$48,224; quartile 2, $48,225-$51,646; quartile 3, $51,647-$59,713; and quartile 4 ≥$59,714
c Three forms of MOUD provided are buprenorphine, methadone, and naltrexone