Health outcomes in infants exposed to opioids are not well-studied, especially for those not diagnosed with neonatal opioid withdrawal syndrome (NOWS). The objective of this study is to determine infant mortality among opioid-exposed infants, along with the differences in risk of mortality in opioid-exposed infants with and without NOWS.

This retrospective cohort study included a total of 1,129,032 maternal-infant dyads, of which 4,238 had paternal opioid exposure, 4,238 had NOWS, and 2,971 did not have NOWS. The primary expose was prenatal opioid exposure and the primary outcome of the study risk of infant mortality.

The results showed that the infant mortality rate was 20 per 1,000 live births among opioid-exposed infants not diagnosed with NOWS, 11 per 1,000 live births among infants with NOWS, and 6 per 1,000 live births among infants with no opioid exposure or NOWS. After adjusting for neonatal and maternal characteristics, mortality in infants with NOWS was not significantly higher than the reference population. Contrastingly, the odds of mortality in opioid-exposed infants not diagnosed with NOWS was 72% higher than the reference group.

The research concluded that opioid-exposed infants were at a higher risk of mortality; however, the diagnosis of NOWS was not significantly associated with mortality in infants.

Ref:  https://jamanetwork.com/journals/jamapediatrics/article-abstract/2778433?resultClick=1