Neonatal abstinence syndrome and early childhood morbidity and mortality in Washington state: a retrospective cohort study

Objective:the objective of the study was to evaluate the association between neonatal abstinence syndrome (nas) and long-term childhood morbidity and infant mortality.study design:we conducted a cohort study of infants born in washington state during 1990 to 2008 who were diagnosed with nas (n=1900) or were unexposed (n=12,283, frequency matched by birth year). 5-year hospital readmissions and infant mortality were ascertained.results:children with history of nas had increased risk of readmission during the first 5 years of life relative to unexposed children; this remained statistically significant after adjustment for maternal age, maternal education, gestational age and intrapartum smoking status (readmission rates: nas=21.3%, unexposed=12.7%, adjusted relative risk (arr) 1.54, 95% confidence interval (ci) 1.37 to 1.73). nas was associated with increased unadjusted infant mortality risk, but this did not persist after adjustment (arr 1.94, 95% ci 0.99 to 3.80).conclusion:the observed increased risk for childhood hospital readmission following nas diagnosis argues for development of early childhood interventions to prevent morbidity.