Table 3.
Maternal demographics, birth parameters, and zip code 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 (2.0, 2.5) | 3.0 (2.7, 3.4) |
| 30–34 | 2.2 (2.0, 2.5) | 4.4 (3.9, 5.0) |
| ≥ 35 | 1.8 (1.6, 2.1) | 3.7 (3.2, 4.3) |
| Maternal race/ethnicity | ||
| Non-Hispanic Asian or Pacific Islander | 0.7 (0.5, 0.9) | 1.0 (0.7, 1.4) |
| Non-Hispanic Black | REF | REF |
| Hispanic | 0.7 (0.6, 0.9) | 0.9 (0.7, 1.1) |
| Non-Hispanic White | 3.6 (3.1, 4.2) | 6.7 (5.8, 7.8) |
| 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 | 8.9 (8.0, 9.8) | 4.8 (4.3, 5.4) |
| Self-pay | 0.4 (0.3, 0.7) | 0.1 (0.1, 0.2) |
| Initiated prenatal care | ||
| No | 4.8 (4.1, 5.6) | 1.8 (1.6, 2.2) |
| Yes | REF | REF |
| Adequacy of Prenatal Care Utilization Index | ||
| Inadequate | 4.1 (3.8, 4.5) | 2.9 (2.6, 3.2) |
| Intermediate | 2.3 (2.1, 2.6) | 2.2 (1.9, 2.5) |
| Adequate or Adequate Plus | REF | REF |
| Any Smoking During Pregnancy | ||
| No | REF | |
| Yes | 5.9 (5.5, 6.4) | 3.3 (3.0, 3.5) |
| Zip code median household income quartile b | ||
| 1 | 3.1 (2.6, 3.8) | 1.4 (1.2, 1.6) |
| 2 | 2.6 (2.1, 3.1) | 1.2 (1.0, 1.4) |
| 3 | 1.8 (1.5, 2.2) | 1.0 (0.8, 1.2) |
| 4 | REF | REF |
Note. NAS = Neonatal Abstinence Syndrome; AOR = adjusted odds ratio; CI = confidence interval; REF = referent group
a Adjusted for all covariates listed and with random intercept included to control for clustering by maternal zip code of residence
b Median household income by zip code in quartile 1 is ≤$46,250; quartile 2, $46,251-$54,872; quartile 3, $54,873-$66,250; and quartile 4 ≥$66,251