Figure 2:
Opioid prescribing 1 to 2 years, 100 days to 1 year and 100 days before delivery in mothers of infants with a diagnosis of neonatal abstinence syndrome between 2007 and 2011 (n = 927 deliveries). ODB = Ontario drug benefit.
| Table 1: Medications prescribed to Ontario Drug Benefit beneficiaries before the birth of an infant with neonatal abstinence syndrome | ||||||
|---|---|---|---|---|---|---|
| Drug | Time period before birth; no. (%) |
|||||
| 1–2 yr | 101 d to 1 yr | 100 d | ||||
|
Any opioid |
619 |
(66.8) |
753 |
(81.2) |
653 |
(70.4) |
|
Opioid treatment for drug dependence |
406 |
(43.8) |
570 |
(61.5) |
547 |
(59.0) |
| Methadone only |
265 |
(28.6) |
428 |
(46.2) |
494 |
(53.3) |
| Methadone and another opioid |
141 |
(15.2) |
142 |
(15.3) |
53 |
(5.7) |
|
Nonmethadone opioid* |
354 |
(38.2) |
325 |
(35.0) |
159 |
(17.2) |
| Oxycodone |
220 |
(23.7) |
185 |
(20.0) |
85 |
(9.2) |
| Hydromorphone |
33 |
(3.6) |
29 |
(3.1) |
17 |
(1.8) |
| Morphine |
35 |
(3.8) |
37 |
(4.0) |
30 |
(3.2) |
| Fentanyl |
16 |
(1.7) |
13 |
(1.4) |
10 |
(1.1) |
| Codeine |
196 |
(21.1) |
161 |
(17.4) |
51 |
(5.5) |
| Other |
11 |
(1.2) |
≤ 5† |
≤ 5† |
||
|
Other psychotropic medication |
495 |
(53.4) |
511 |
(55.1) |
283 |
(30.5) |
| Sedative–hypnotic agent |
247 |
(26.6) |
232 |
(25.0) |
123 |
(13.3) |
| Barbiturates |
0 |
(0) |
0 |
(0) |
0 |
(0) |
| Anticonvulsant agent |
16 |
(1.7) |
14 |
(1.5) |
≤ 5† |
|
| Cyclic antidepressant |
178 |
(19.2) |
157 |
(16.9) |
38 |
(4.1) |
| Noncyclic antidepressant |
324 |
(34.9) |
312 |
(33.7) |
155 |
(16.7) |
| Antipsychotic agent |
164 |
(17.7) |
165 |
(17.8) |
85 |
(9.2) |
| Stimulant |
34 |
(3.7) |
31 |
(3.3) |
16 |
(1.7) |
| Lithium | 16 | (1.7) | 17 | (1.8) | ≤ 5† | |
*Excluding buprenorphine. †In accordance with institutional policy, the exact number is suppressed when the cell size is ≤ 5.
| Table 2: Characteristics of mothers who were beneficiaries of the public drug plan and their infants in cases of neonatal abstinence syndrome, Jan. 1, 2007 to Dec. 31, 2010 | |||||
|---|---|---|---|---|---|
| Characteristic | No. (%)* |
p value | |||
| Opioids prescribed in the 100 d before birth n = 421 |
Opioids not prescribed in the 100 d before birth n = 197 |
||||
|
Infants |
|||||
| Gestational age, wk, median (IQR) |
39 |
(37–40) |
38 |
(37–40) |
0.15 |
| Birth weight, g, median (IQR) |
2990 |
(2685–3391) |
2947 |
(2615–3370) |
0.28 |
| Male sex |
202 |
(48.0) |
97 |
(49.2) |
0.77 |
|
Mothers |
|||||
| Age, yr, median (IQR) |
27.5 |
(24.5–31.8) |
27.8 |
(24.7–32.3) |
0.46 |
| Cesarean delivery |
127 |
(30.2) |
43 |
(21.8) |
0.03 |
| Neighbourhood income quintile |
|||||
| Lowest |
210 |
(50.0) |
83 |
(42.1) |
0.07 |
| Second lowest |
83 |
(19.7) |
50 |
(25.4) |
0.11 |
| Middle |
58 |
(13.8) |
31 |
(15.7) |
0.52 |
| Second highest |
38 |
(9.0) |
19 |
(9.6) |
0.80 |
| Highest |
31 |
(7.4) |
12 |
(6.1) |
0.56 |
|
First NAS-related admission to hospital |
|||||
| Birth |
396 |
(94.1) |
175 |
(88.8) |
0.02 |
| Infant admission to NICU |
339 |
(80.5) |
155 |
(78.7) |
0.59 |
| Length of stay, d, median (IQR) |
19 |
(9–31) |
10 |
(5–20) |
< 0.0001 |
|
Year following birth (infant) |
|||||
| Mortality |
≤ 5† |
0 |
(0) |
NA |
|
| Outpatient physician encounters, median (IQR) |
25 |
(16–38) |
17 |
(12–27) |
< 0.001 |
| Admissions to hospital, no., median (IQR) |
1 |
(1–1) |
1 |
(1–1) |
0.834 |
| Visits to emergency department, no., median (IQR) |
1 |
(0–2) |
0 |
(0–2) |
0.004 |
| Note: IQR = interquartile range, NA = not available, NAS = neonatal abstinence syndrome, NICU = neonatal intensive care unit. *Unless otherwise indicated. †In accordance with institutional policy, the exact number is suppressed when the cell size is ≤ 5. | |||||
