Rooming-in compared with standard care for newborns of mothers using methadone or heroin.
OBJECTIVE
To evaluate the effect of rooming-in (rather than standard nursery care) on the incidence and severity of neonatal abstinence syndrome among opioid-exposed newborns and on the proportion of mothers who retain custody of their babies at hospital discharge.


METHODS
Retrospective cohort study.


METHODS
Lower mainland in southwestern British Columbia.


METHODS
We selected 32 women in the city of Vancouver known to have used heroin or methadone during pregnancy between October 2001 and December 2002. Comparison groups were a historical cohort of 38 women in Vancouver and a concurrent cohort of 36 women cared for in a neighbouring community hospital.


METHODS
Need for treatment with morphine, number of days of treatment with morphine, and whether babies were discharged in the custody of their mothers.


RESULTS
Rooming-in was associated with a significant decrease in need for treatment of neonatal abstinence syndrome compared with the historical cohort (adjusted relative risk [RR] 0.40, 95% confidence interval [CI] 0.20 to 0.78) and the concurrent cohort (adjusted RR 0.39, 95% CI 0.20 to 0.75). Rooming-in was also associated with shorter newborn length of stay in hospital compared with both comparison groups. Newborns who roomed in at BC Women's Hospital were significantly more likely to be discharged in the custody of their mothers than babies in the historical cohort (RR 2.23, 95% CI 1.43 to 3.98) or the concurrent cohort (RR 1.52, 95% CI 1.15 to 2.53) were.


CONCLUSIONS
Rooming-in might ease opioid-exposed newborns' transition to extrauterine life and promote more effective mothering.
Abrahams
Ronald R
RR
UBC Department of Health Care and Epidemiology, 5804 Fairview Ave, Vancouver, BC.
Kelly
S Ann
SA
Payne
Sarah
S
Thiessen
Paul N
PN
Mackintosh
Jessica
J
Janssen
Patricia A
PA
D000328:Adult; D001942:Breast Feeding / Q000706:statistics & numerical data; D001955:British Columbia / Q000453:epidemiology; D002655:Child Custody / Q000706:statistics & numerical data; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D003932:Heroin / Q000009:adverse effects*; D006801:Humans; D007231:Infant, Newborn; D007902:Length of Stay / Q000706:statistics & numerical data; D008691:Methadone / Q000009:adverse effects*; D009357:Neonatal Abstinence Syndrome / Q000453:epidemiology* / Q000209:etiology*; D009293:Opioid-Related Disorders / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology; D015995:Prevalence; D012386:Rooming-in Care / Q000706:statistics & numerical data*; D012907:Smoking / Q000453:epidemiology; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000453:epidemiology
D003932:Heroin; D008691:Methadone