Within-Hospital Concordance of Opioid Exposure Diagnosis Coding in Mothers and Newborns.

TitleWithin-Hospital Concordance of Opioid Exposure Diagnosis Coding in Mothers and Newborns.
Publication TypeJournal Article
Year of Publication2021
AuthorsClark RRS, French R, Lorch S, O'Rourke K, Rosenbaum KEFitzpatr, Lake ET
JournalHosp Pediatr
Date Published2021 Jul 06
ISSN2154-1671
Abstract

BACKGROUND AND OBJECTIVES: We measured within-hospital concordance of mothers with opioid use disorder (OUD) and newborns with neonatal abstinence syndrome (NAS) or opioid exposure (OE). Secondarily, we described the demographics of mothers and newborns with and without opioid-related diagnoses.

METHODS: We used hospital discharge abstracts from California, Florida, New Jersey, and Pennsylvania in 2016. Descriptive statistics were used to compare newborns and mothers with and without opioid-related diagnoses. Within-hospital frequencies of mothers with OUD and newborns with NAS and OE were compared. Pearson's correlation coefficients were calculated.

RESULTS: In 474 hospitals, we found 896 702 mothers (0.6% with OUD) and 910 867 newborns (0.47% with NAS, 0.85% with OE, and 0.07% with both). Although the frequency of mothers and newborns with opioid-related diagnoses in a hospital was strongly correlated ( = 0.81), more infants were identified than mothers in most hospitals (68.3%). Mothers with OUD were more likely to be white (79% vs 40.9%), on Medicaid (75.4% vs 44.0%), and receive care in rural hospitals (20.6% vs 17.6%), compared with mothers without OUD. Newborns with NAS had demographics similar to women with OUD. Newborns with OE were disproportionately Black (22% vs 7%) or Hispanic (22% vs 9%).

CONCLUSIONS: More newborns are diagnosed with opioid-related disorders than mothers are. Although infants diagnosed with NAS had demographics similar to mothers with OUD, infants with OE were more likely to be Black or Hispanic. The lack of diagnostic coding of maternal OUD and the racial differences in diagnoses warrant attention.

DOI10.1542/hpeds.2020-003863
Alternate JournalHosp Pediatr
PubMed ID34230061