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The association between intrauterine exposure to opioids, tobacco, alcohol, and cannabis and length of birth hospitalization among neonates without NOWS

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Data availability

The datasets for this paper are not publicly available because, per the NIH-approved ECHO Data Sharing Policy, ECHO-wide data have not yet been made available to the public for review/analysis. Requests to access the datasets should be directed to the ECHO Data Analysis Center,


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The authors wish to thank our ECHO colleagues, the medical, nursing and program staff, as well as the children and families participating in the ECHO cohorts. We also acknowledge the contribution of the following ECHO program collaborators: ECHO Components—Coordinating Center: Duke Clinical Research Institute, Durham, North Carolina: Smith PB, Newby KL; ECHO Awardees and Cohorts—Massachusetts General Hospital, Boston, MA: Camargo C; Emory University, Atlanta, GA: Dunlop A; University of South Dakota, Vermillion, SD: Elliot A; Kaiser Foundation Research Institute, Oakland, CA: Ferrara A; University of California, Davis, Sacramento CA: Hertz-Picciotto I; University of Rochester Medical Center, Rochester, NY: O’Connor T; Magee-Women’s Research Institute & Foundation, Pittsburgh, PA: Simhan H; University of Utah, Salt Lake City, UT: Stanford J.


Research reported in this publication was supported by the Environmental influences on Child Health Outcomes (ECHO) Program, Office of The Director, National Institutes of Health, under Award Numbers U2COD023375 (Coordinating Center), U24OD023382 (Data Analysis Center), U24OD023319 (PRO Core), UH3OD023253 (PI Camargo), UH3OD023318 (PI Dunlop), and UH3OD023279 (PI Elliot). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Authors and Affiliations



AS, AK, MM, RA, RN, SO, CC, and AD made substantial contributions to the concept and design; the acquisition, analysis, or interpretation of the data; and writing and revising the paper. GP and LC made substantial contributions to the concept and design; the interpretation of the data; and revising the paper. AE, LA, MH, PB, and MB made substantial contributions to the interpretation of the data and revising the paper. SS and XL made substantial contributions to the acquisition, analysis, and interpretation of the data and revising the paper. All authors have approved the final version of the paper and agree to be accountable for all aspects of the work.

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Correspondence to Steven J. Ondersma.

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Competing interests

The authors declare no competing interests.

Ethics approval and consent to participate

All original data collection as well as the present analyses were performed in accordance with the Declaration of Helsinki. The study protocol was approved by the local [or single ECHO] institutional review board. Written informed consent or parent’s/guardian’s permission was obtained along with child assent as appropriate, for ECHO-wide Cohort Data Collection Protocol participation and for participation in specific cohorts.

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Ondersma, S.J., Kress, A.M., Stroustrup, A. et al. The association between intrauterine exposure to opioids, tobacco, alcohol, and cannabis and length of birth hospitalization among neonates without NOWS. J Perinatol 43, 949–951 (2023).

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