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Association between pharmacologic treatment and hospital utilization at birth among neonatal opioid withdrawal syndrome mother-infant dyads



We linked mother-baby dyads to explore associations between maternal medication-assisted therapy (MAT) and infants’ pharmacologic treatment on birth hospital utilization for infants with NOWS.


We extracted singleton infant and maternal delivery discharges from PHIS hospitals with large volumes of deliveries for 2016–2019. We matched newborns with NOWS to maternal delivery discharges by hospital, day of birth, mode of delivery, and ZIP code. We examined the association between maternal MAT, infants’ pharmacologic treatment, and hospital utilization at birth.


We included N = 146 mother-baby dyads from six hospitals (74% match rate). Among matched dyads, 51% received maternal MAT, 60% pharmacotherapy (37% both). Infants treated non-pharmacologically and born to mothers receiving MAT had the shortest stays vs. infants without pharmacotherapy or MAT (RR = 0.29; 95% CI: 0.25–0.35).


These findings underscore the importance of adequate perinatal treatment for opioid use disorder to improve outcomes for mothers and infants with opioid exposure.

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Fig. 1: Adjusted associations between maternal MAT and infants’ pharmacologic treatment.
Fig. 2: Adjusted associations between maternal MAT and infants’ pharmacologic treatment on utilization during birth hospitalization.

Data availability

The datasets analyzed in this study are not publicly available as they were acquired through the Pediatric Health Information System which prohibits data sharing outside of its member hospitals.


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Author information

Authors and Affiliations



CEM conceptualized and designed the study and planned the analyses with input from PDH, AO, PM, and DAG. With input from CEM, PDH acquired and analyzed the data. CEM, PDH, PM and DAG reviewed and interpreted statistical output. PDH and CEM drafted the initial manuscript. All authors reviewed and revised the manuscript. All authors approved the final manuscript as submitted.

Corresponding author

Correspondence to Carly E. Milliren.

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The authors declare no competing interests.

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The authors declare no competing interests.This study was performed in accordance with the Declaration of Helsinki. This study used de-identified administrative billing data and was considered not human subjects research by the Institutional Review Board at Boston Children’s Hospital.

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Hahn, P.D., Melvin, P., Graham, D.A. et al. Association between pharmacologic treatment and hospital utilization at birth among neonatal opioid withdrawal syndrome mother-infant dyads. J Perinatol 43, 283–292 (2023).

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