Adverse neonatal outcomes associated with maternal severe mental health diagnoses and opioid use.

Objective: Determine odds ratios for neonatal abstinence syndrome (NAS) and neonatal intensive care unit (NICU) admissions for babies born to women associated with severe mental illness (SMI) and gestational opioid use.

Study Design: A retrospective pharmacoepidemiologic study using Medicaid data included 17,130 mothers with and 170,430 mothers without SMI, and their babies. Odds ratios for NAS and NICU admissions among babies born to mothers associated with SMI diagnoses and associated with varying degrees of gestational opioid use were determined using logistic regression.

Results: The adjusted odds ratio for a baby in the methadone or buprenorphine group having NAS was 168.93 [95% confidence interval (CI) 148.78-191.71, P < 0.001] and was 9.64 (95% CI 8.74-10.65, P < 0.001) for NICU admissions compared to babies with no opioid exposure.

Conclusions: Chronicity of prescription maternal opioid use was the strongest factor associated with NAS and NICU admissions.