Prenatal Drug and Related Exposures in Infant Patients of a Northeast Tennessee Pediatric Primary Care Clinic

Introduction: The prevalence of opioid abuse has increased throughout Northeast Tennessee. Subsequently, more infants are born drug-exposed or with Neonatal Abstinence Syndrome (NAS). According to the Tennessee Department of Health, hospitalizations for deliveries with maternal substance abuse tripled in Tennessee between 1999 and 2011. During this period, the inpatient hospitalization rate for NAS increased 11-fold. In 2017, there were 163 NAS cases reported in Northeast Tennessee. The purpose of this research was to describe the prevalence of drug exposure (study 1) and compare opiate vs. non drug-exposed infants to explore for differences in demographics, risk factors, and pediatric health conditions (study 2). Methods: This cross-sectional study was set in a Northeast Tennessee pediatric clinic. An 83-item template was develop for chart abstraction. For study 1, 120 patients were randomly selected from those seen for newborn visits between June 30, 2013 and July 1, 2014. Data were independently abstracted by two research assistants, with 80% of charts cross-checked to ensure similar abstraction methods. For study 2, an additional sample of all infants with suspected drug exposure was identified for this period based on diagnosis codes. For study 2, all opiate-exposed infants were compared to non drug-exposed infants. The Pearson Chi-Square test and Mann-Whitney U test were used, with a critical value of p