Reports
Annual Reports
- Ohio National Birth Defects Prevention Network (NBDPN) 2020 Annual Report Data
- Ohio Connections for Children with Special Needs (OCCSN) Annual Report 2019
Neonatal Abstinence Syndrome (NAS) Hospital Reporting
Neonatal Abstinence Syndrome (NAS) Hospital Reporting
NAS is a serious withdrawal syndrome that can occur in newborns after exposure to opioids during pregnancy.
Ohio Revised Code 3711.30, which went into effect on July 10, 2014, requires maternity units, newborn care nurseries and maternity homes to report to the Ohio Department of Health (ODH) the number of newborns born to Ohio residents who are diagnosed with opioid dependence, commonly referred to as "NAS," at birth.
In order to assist hospitals in complying with this law, ODH partners with the Ohio Hospital Association (OHA) to access hospital discharge data associated with NAS. As a result of this partnership, Ohio hospitals that report their discharge data to OHA do not need to report to ODH in order to comply with the law; ODH obtains the required data from OHA’s discharge dataset.
Facilities that do not report data to OHA should contact ODH at HealthyOhio@odh.ohio.gov for instructions on how to report.
NAS Hospital Discharge Data Summaries
2023 Hospital Discharge Data Summary Table
Key Findings:
- From 2019 to 2023, there were approximately 7,309 hospital discharges due to NAS among Ohio residents in Ohio hospitals. Of those, 1,156 were in 2023.
- From 2019 to 2023, the hospital discharge rate of NAS decreased nearly 27% (123.6 per 10,000 live hospital births to 90.6 per 10,000).
- In 2023, Medicaid covered 88% of hospital discharges for NAS and 43% of all Ohio inpatient birth discharges.
- The average length of stay (LOS) for NAS has fluctuated throughout the years. In 2023, the average LOS for NAS (14.9 days) was nearly 4 times higher than the average LOS for all Ohio births (3.8 days).
- In 2023, there were 385 hospitalizations among Ohio resident newborns associated with cocaine exposure, 1,061 associated with opioid exposure, 21 associated with sedative-hypnotic exposure, 23 associated with anxiolytic exposure, 703 associated with exposure to other drugs of addiction, and 155 associated with exposure to unspecified drugs of addiction. Among Ohio resident newborns, hospitalizations associated with opioid exposure decreased by 9% in 2023 compared to 2022.
- When compared to all Ohio resident infants born in Ohio hospitals in 2023, a significantly higher percentage of infants with NAS had feeding difficulties, low birth weight, respiratory symptoms, and seizures and convulsions.
Past Summaries
2022 Hospital Discharge Data Summary Table
2021 Hospital Discharge Data Summary Table
2020 Hospital Discharge Data Summary Table
2018 Hospital Discharge Data Summary Table
*Note: Counts may not reflect unique individuals, as individuals may have been hospitalized multiple times for NAS.
NAS County Reports
Ohio Data by County, 2018-2022
Ohio Data by County, 2017-2021
Ohio Data by County, 2016-2020
Ohio Data by County, 2014-2018
Ohio Data by County, 2013-2017
Recommendations to Prevent NAS
- All newborns and at-risk breastfeeding children should be screened for NAS symptoms with standardized instruments like the Finnegan Neonatal Abstinence Scoring Tool.1 Hospital systems should hold mandatory trainings for staff with annual refresher trainings to ensure inter-rater reliability when scoring the instrument.
- The American Academy of Pediatrics suggests that all infants exposed to opioids be monitored for signs of withdrawal for four to seven days after birth.2,3 Physicians, other healthcare professionals and families should be educated about the signs and symptoms of NAS. A guide for families has been developed by the Ohio Perinatal Quality Collaborative.4
- Promising practices in treatment of NAS should be identified and promoted throughout the state. Ohio’s standard of care for NAS follows state and national research and is updated regularly as new information becomes available.5
- Women delivering NAS infants should be provided with information about the special needs of their newborns.
- Screening, brief intervention and referral to treatment (SBIRT) should be the standard in all medical practices.6 Healthcare providers should confirm suspicion of alcohol or drug use with questionnaires like the NIDA Drug Screening Tool7 or with a urine drug screen. Pregnant women found to be addicted to or dependent on substances should be referred to behavioral health treatment as soon as possible. The Ohio Department of Mental Health and Addiction Services has a referral gateway to Ohio behavioral health professionals.8
- Women of childbearing age being treated for substance use disorder should be counseled on the impact of substance use on pregnancy; these women should also be screened for hepatitis C and HIV because of the high comorbidity.
- All healthcare organizations that treat pregnant women, including those that address behavioral health, should consider establishing a maternal care home like the maternal opiate medical supports (MOMS) program.9 This model emphasizes care coordination and the provision of wrap around services from the prenatal phase through the postpartum phase of care. Results from this project have shown improved uptake of prenatal care, behavioral healthcare and medication-assisted treatment as well as an increase in treatment retention and family stability.
- Alcohol and drug abuse prevention activities should be targeted to women of child-bearing age.
- Prescribers should carefully consider whether opioid analgesics and other medications should be used during pregnancy. Physicians and patients should consult resources like the Treating for Two campaign about medication and pregnancy to make informed decisions.10
References:
1Ohio Perinatal Quality Collaborative (2018). Finnegan neonatal abstinence scoring tool.
2 Hudak M. L. & Tan R. C. (2012). Committee on drugs committee on fetus and newborn. American Academy of Pediatrics. Clinical Report. Neonatal drug withdrawal. Pediatrics, 129(2), 540-560. doi:10.1542/peds.2011-3212 pmid:22291123.
3 Patrick, S. W., Cooper, W. O., & Davis, M. M. (2017). Prescribing opioids and psychotropic drugs in pregnancy. British Medical Journal, 358, 3616 doi: 10.1136/bmj.j3616.
4 Ohio Perinatal Quality Collaborative (2018). Neonatal abstinence syndrome: A guide for families.
5 Ohio Perinatal Quality Collaborative (2017). Updates/changes to the recommended OPQC NAS protocol.
6 Ohio Department of Mental Health and Addiction Services (2018). Screening, brief intervention and referral to treatment.
7 National Institute on Drug Abuse (2018). NIDA drug screening tool.
8 Emerald Jenny Foundation (2018). This is the first step.
9 Ohio Department of Mental Health and Addiction Services (2018). M.O.M.S.
10 Centers for Disease Control and Prevention (2018). Treating for two: Medicine and pregnancy.