Substance use during pregnancy: impact on Colorado community hospital
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Journal of Cannabis Research
(2020) 2:39
ORIGINAL RESEARCH
Open Access
Substance use during pregnancy: impact on Colorado community hospital Jacinda Heintzelman1*, Lisa Persons1 and Igor Melnykov2
Abstract Background: Neonatal Abstinence Syndrome (NAS) leads to increased length of stay (LOS), which leads to increased healthcare costs, and can cause financial burdens for hospitals. The purpose of the study was to determine the impact of substance use by pregnant women on a Colorado (CO) community hospital after state legalization of recreational cannabis. Methods: Data were gathered retrospectively through the electronic health record at an inpatient facility and described 607 mothers and 419 newborns (total N = 1026) who tested positive for drugs (urinalysis or blood for mother and urine, meconium, or cord blood for newborns). Screening for drugs was at discretion of healthcare provider if mother reported use or newborn showed symptoms of NAS. The patients who were not screened or tested negative were excluded from consideration. Newborns exposed to cannabis were compared to those exposed to other drugs (opioids, methadone, cocaine, barbiturates, benzodiazepines, amphetamines) on costs of newborn hospitalization, based on type of newborn bed and length of stay (LOS). Group comparisons were done using Cochran-Armitage chi-square tests and two-sample t-tests. Results: The proportion of screened patients testing positive for illicit and prescribed substances increased significantly from 2013 (33.4%) to 2017 (50.2%) (p < 0.001). The LOS of drug-exposed newborns increased significantly over the years (p < 0.0001). Newborns testing positive for cannabis were more likely to remain in a normal newborn nursery (NSY) bed (69.8%) than those testing positive for other drugs (27.7%), with an average hospital LOS (4.6 days) significantly shorter (p < 0.001) than that of other-drug exposed newborns (14.2 days). Combined healthcare costs for other-drug exposed newborns ($23,495,221) were significantly higher (p < 0.001) than for cannabis-exposed newborns ($2,885,139); both groups had significantly higher costs (p < 0.001) than normal healthy newborns ($2,166,649). Conclusion: Drug-exposed newborns have a significant financial impact on hospital healthcare costs, largely due to more expensive bed placement and longer LOS. Keywords: Pregnancy, Newborn, Substance use, Cannabis, Healthcare costs
Background The current use of illicit and prescribed substances in the United States (U.S.) is considered a national crisis, and pregnant women cannot be ignored in this situation since a newborn may be negatively affected through intrauterine exposure. Newborn exposure can lead to an increased length of stay (LOS) and an increase in * Correspondence: [email protected] 1 Colorado State University-Pueblo, Pueblo, USA Full list of author information is available at the end of the article
healthcare costs when compared to a normal healthy newborn, and negatively affect hospitals. When a mother ingests addictive substances,
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