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Racial association and pharmacotherapy in neonatal opioid withdrawal syndrome

Journal of Perinatology volume 39, pages 1370–1376 (2019)Cite this article

Subjects

Abstract

Objective

To determine if racial differences are associated with Neonatal Opioid Withdrawal Syndrome (NOWS) severity.

Study design

A 10-year (2008–2017) retrospective cohort of infants ≥35 weeks gestation with prenatal exposure to opioids was included. The primary measure was the need for pharmacotherapy. Multivariable logistic regression and propensity score analysis were performed.

Results

Among 345 infants with NOWS, 111 (32%) were black infants with 70% of them requiring pharmacotherapy as compared with 84% of white infants. Upon adjusting for significant covariates (methadone, benzodiazepine use, and gestational age), black infants were 57% less likely than whites to require pharmacotherapy (Odds ratio: 0.43, 95%CI: 0.22–0.80, p = 0.009). Similar results were observed with propensity score analysis.

Conclusions

Significant racial disparity observed may be secondary to genetic variations in opioid pharmacogenomics and/or extrinsic factors. Large-scale studies are warranted to include race in predictive models for early pharmacological intervention.

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Acknowledgements

We would like to thank our multidisciplinary team at the University of Maryland Medical center, including nurses, nurse practitioners, and physicians who are constantly involved in taking care of these patients. We would also like to thank Ms. Kelly Tracey in helping us identify patients for this review.

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Authors and Affiliations

  1. University of Maryland Medical Center, Baltimore, MD, USA

    Abhinav Parikh, Anastasia Booth & Dina El-Metwally

  2. Center for Translational Medicine, School of Pharmacy, University of Maryland, Baltimore, MD, USA

    Mathangi Gopalakrishnan

  3. Long Island Jewish Forrest Hill Hospital, Forrest Hill, NY, 11375, USA

    Ahad Azeem

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Correspondence to Abhinav Parikh.

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Parikh, A., Gopalakrishnan, M., Azeem, A. et al. Racial association and pharmacotherapy in neonatal opioid withdrawal syndrome. J Perinatol 39, 1370–1376 (2019). https://doi.org/10.1038/s41372-019-0440-8

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