Original Article

Newborn Congenital Malformations Associated With Prenatal Exposure to Drugs in Kentucky, 2009–2013

Authors: Terry L. Bunn PhD, Betty J. Ouyang MD, Svetla Slavova PhD

Abstract

Objectives: This study examined associations between prenatal drug exposures and congenital organ system malformation diagnoses in newborns (at birth) and infants (hospitalizations after birth up to 30 days of age) in Kentucky.

Methods: Data were obtained from Kentucky inpatient hospitalization records for newborns and for infants from 2009 to 2013. Prenatal drug exposures and congenital anomalies were identified using International Classification of Diseases, Ninth Revision, Clinical Modification codes for prenatal drug exposures (760.70–760.79; 304; 779.5) and congenital anomalies (740–759). Descriptive analyses and logistic regression were performed.

Results: Neonatal abstinence syndrome was the most frequent prenatal drug exposure–related diagnosis in newborns (1%). Cardiac and circulatory malformation diagnoses were significantly elevated in newborns prenatally exposed to drugs compared with cardiac and circulatory malformation diagnoses in newborns with no prenatal drug exposures ( P < 0.0001); genital and urinary anomalies also were significantly elevated among newborns with prenatal drug exposures ( P < 0.05). Newborns and infants diagnosed as having congenital malformations who were prenatally exposed to drugs had significantly extended hospitalization stays and higher total hospitalization charges compared with newborns and infants diagnosed as having congenital malformations who were not prenatally exposed to drugs ( P < 0.0001).

Conclusions: Further research is needed to identify specific risk factors (eg, drug classes, tobacco) and toxicities (eg, intake amount, frequency of intake, drug metabolism) associated with congenital malformation diagnoses following prenatal exposure to drugs.

This content is limited to qualifying members.

Existing members, please login first

If you have an existing account please login now to access this article or view purchase options.

Purchase only this article ($25)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.

References

1. Results from the 2013 National Survey on Drug Use and Health: Summary of National Findings. NSDUH Series H-48, HHS Publication No. (SMA) 14-4863. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2014.
 
2. Bada HS, Das A, Bauer CR, et al. Low birth weight and preterm births: etiologic fraction attributable to prenatal drug exposure. J Perinatol 2005;25:631-637.
 
3. Patrick SW, Schumacher RE, Benneyworth BD, et al. Neonatal abstinence syndrome and associated health care expenditures: United States, 2000-2009. JAMA 2012;307:1934-1940.
 
4. Hudak ML, Tan RC, Committee on Drugs, et al. Neonatal drug withdrawal. Pediatrics 2012;129:e540-e560.
 
5. Roussos-Ross K, Reisfield G, Elliot I, et al. Opioid use in pregnant women and the increase in neonatal abstinence syndrome: what is the cost? J Addict Med 2015;9:222-225.
 
6. Koren G, Nulman I, Chudley AE, et al. Fetal alcohol spectrum disorder. CMAJ 2003;169:1181-1185.
 
7. Scher MS, Richardson GA, Day NL. Effects of prenatal cocaine/crack and other drug exposure on electroencephalographic sleep studies at birth and one year. Pediatrics 2000;105(1 Pt 1):39-48.
 
8. Mactier H. Neonatal and longer term management following substance misuse in pregnancy. Early Hum Dev 2013;89:887-892.
 
9. O’Leary CM, Nassar N, Kurinczuk JJ, et al. Prenatal alcohol exposure and risk of birth defects. Pediatrics 2010;126:e843-e850.
 
10. Vucinovic M, Roje D, Vucinovic Z, et al. Maternal and neonatal effects of substance abuse during pregnancy: our ten-year experience. Yonsei Med J 2008;49:705-713.
 
11. van Gelder MM, Reefhuis J, Caton AR, et al. Maternal periconceptional illicit drug use and the risk of congenital malformations. Epidemiology 2009;20:60-66.
 
12. Lester BM, Lagasse LL, Shankaran S, et al. Prenatal cocaine exposure related to cortisol stress reactivity in 11-year-old children. J Pediatr 2010;157:288-295.e1.
 
13. Centers for Disease Control and Prevention. Urogenital anomalies in the offspring of women using cocaine during early pregnancy--Atlanta, 1968-1980. MMWR Morb Mortal Wkly Rep 1989;38:536, 541-542.
 
14. Broussard CS, Rasmussen SA, Reefhuis J, et al. Maternal treatment with opioid analgesics and risk for birth defects. Am J Obstet Gynecol 2011;204:314.e1-e11.
 
15. Yazdy MM, Mitchell AA, Tinker SC, et al. Periconceptional use of opioids and the risk of neural tube defects. Obstet Gynecol 2013;122:838-844.
 
16. Cleary BJ, Eogan M, O’Connell MP, et al. Methadone and perinatal outcomes: a prospective cohort study. Addiction 2012;107:1482-1492.