Characteristics and causes of death in children with neonatal abstinence syndrome

Hannah Uebel; Ian M Wright; Lucinda Burns; Lisa Hilder; Barbara Bajuk; Courtney Breen; Mohamed E Abdel-Latif; Janet Falconer; Sarah Clews; Meredith Ward; John Eastwood; Ju Lee Oei

doi:10.1111/jpc.15091

Characteristics and causes of death in children with neonatal abstinence syndrome

J Paediatr Child Health. 2020 Dec;56(12):1933-1940. doi: 10.1111/jpc.15091. Epub 2020 Aug 20.

Authors

Hannah Uebel^{1

2}, Ian M Wright^{3

4}, Lucinda Burns⁵, Lisa Hilder⁵, Barbara Bajuk⁶, Courtney Breen⁵, Mohamed E Abdel-Latif^{7

8}, Janet Falconer⁹, Sarah Clews⁹, Meredith Ward^{1

10}, John Eastwood^{1

11

12

13

14}, Ju Lee Oei^{1

10

14}

Affiliations

¹ School of Women's and Children's Heath, University of New South Wales, Sydney, New South Wales, Australia.
² Department of Paediatrics, Sydney Children's Hospital, Sydney, New South Wales, Australia.
³ College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia.
⁴ Illawarra Health and Medical Research Institute, University of Wollongong, Camperdown, NSW, Australia.
⁵ National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia.
⁶ Perinatal Services Network, Sydney Children's Hospital, Sydney, New South Wales, Australia.
⁷ Department of Neonatology, The Canberra Hospital, Canberra, Australian Capital Territory, Australia.
⁸ Faculty of Medicine, The Australian National University, Canberra, Australian Capital Territory, Australia.
⁹ The Langton Centre, Sydney, New South Wales, Australia.
¹⁰ Department of Newborn Care, Royal Hospital for Women, Sydney, New South Wales, Australia.
¹¹ Department of Community Pediatrics, Sydney Local Health District, Sydney, New South Wales, Australia.
¹² Sydney Medical School, University of Sydney, Camperdown, NSW, Australia.
¹³ Sydney Institute for Women Children and their Families, Camperdown, NSW, Australia.
¹⁴ Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia.

PMID: 32815631
DOI: 10.1111/jpc.15091

Abstract

Aim: To determine characteristics of death in children with neonatal abstinence syndrome (NAS).

Methods: A population-based linkage study of children from birth to 13 years of age in New South Wales (NSW), Australia, born 1 July 2000 to 31 December 2011. Infants with an International Statistical Classification of Diseases and Related Problems, Australian modification coding of NAS (P96.1, n = 3842) were compared to infants (n = 1 018 421) without NAS by birth, hospitalisation and death records linkage.

Results: Forty-five (1.2%) children with NAS died, compared to 3665 (0.4%) other children. Most deaths (n = 30, 66%) in NAS children occurred between 1 month and 1 year. Risk of death was independently increased in full-term children (hazard ratio 2.34, 95% confidence interval 1.63-3.35; P < 0.001) from lower socio-economic groups (1.23, 1.12-1.35; P < 0.001), most commonly from ill-defined or external causes, including assault and accidents (P < 0.001).

Conclusions: Children with NAS, especially those of term gestation and from lower socio-economic groups, are more likely to die, especially from external causes.

Keywords: childhood mortality; linkage; neonatal abstinence syndrome.

MeSH terms

Australia
Cause of Death
Child
Hospitalization
Humans
Infant
Infant, Newborn
Neonatal Abstinence Syndrome*
New South Wales / epidemiology
Retrospective Studies