Variation in Rates of Neonatal Opioid Withdrawal Syndrome and Opioid-related Hospitalizations in New York State, 2018

Rates of neonatal opioid withdrawal syndrome (NOWS) among infants and opioid-related hospitalizations among adults have increased in recent decades. We examined rates of NOWS births and opioid-related hospitalizations among adult females of childbearing age overall and by sociodemographic and geographic factors using hospitalization data.

We used data from the New York State Inpatient Database for 2018 from the Healthcare Cost and Utilization Project. We identified infants with NOWS and opioid-related hospitalizations using diagnosis codes and calculated rates of NOWS per 1,000 live births and opioid-related hospitalizations per 1,000 hospitalizations among females of childbearing age. We compared rates by geographic and sociodemographic factors and examined the correlation between county-level rates.

The NOWS rate was 4.66 per 1,000 live births, while the rate of opioid-related hospitalizations was 36.6 per 1,000 hospitalizations. There was variation by county and sociodemographic factors including urban-rural classification, race and ethnicity, insurance payer, and median income. We found the highest rates for both NOWS and opioid-related hospitalizations in non-metropolitan areas, among patients with public insurance, and among non-Hispanic White or Native American populations. There was a significant linear correlation (r=0.28; p=0.03) between county-level rates; however, only 32% of counties were concordant in quartiles for both measures.

Our findings indicate variation in rates of NOWS and opioid-related hospitalizations by geographic and sociodemographic factors, with only moderate concordance in county-level rates. These findings may provide a nuanced interpretation by examining measures impacting both women and infants and have important implications in prioritizing treatment access.