title: Risk of Hospital Readmission Among Infants With Neonatal Abstinence Syndrome.
abstract: OBJECTIVE
  Neonatal abstinence syndrome (NAS) is a postnatal drug withdrawal syndrome that may last for months. Our objective was to determine if infants with NAS are at increased risk for hospital readmission compared with uncomplicated term and late preterm newborns.
  
  
  METHODS
  In this longitudinal retrospective cohort study, administrative data were used for all births from 2006 to 2009 in the New York State Inpatient Database. We identified infants with NAS, born late preterm or uncomplicated term, as independent groups using diagnostic codes and determined readmission rates. We fit a multivariable logistic regression model with 30-day readmission after discharge as the outcome and infant characteristics, clinical morbidities, insurance type, and length of birth hospitalization as predictors.
  
  
  RESULTS
  From 2006 to 2009 in New York State, 700 613 infants were classified as uncomplicated term, 51 748 were born late preterm, and 1643 infants were diagnosed with NAS. After adjusting for confounders, infants with NAS (odds ratio [OR] 2.49, 95% confidence interval [CI] 1.75-3.55) were more likely than uncomplicated term infants to be readmitted within 30 days of birth hospitalizations. The risk of readmission was similar to late preterm infants (OR 2.26, 95% CI 2.09-2.45). Length of birth hospitalization in days was inversely related to odds of being readmitted within 30 days of birth hospitalization (OR 0.94 95% CI 0.92-0.96).
  
  
  CONCLUSIONS
  When compared with uncomplicated term infants, infants diagnosed with NAS were more than twice as likely to be readmitted to the hospital. Future research and state-level policies should investigate means to mitigate risk of hospital readmission for infants with NAS.
authors.affiliation: Departments of Pediatrics, and Mildred Stahlman Division of Neonatology, Vanderbilt University, Nashville, Tennessee; Vanderbilt Center for Health Services Research, Nashville, Tennessee; Health Policy, and stephen.patrick@vanderbilt.edu.
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Patrick
authors.affiliation: Department of Neurology, and.
authors.forename: James F
authors.initials: JF
authors.lastname: Burke
authors.affiliation: School of Medicine, University of Michigan, Ann Arbor, Michigan; and.
authors.forename: Terry J
authors.initials: TJ
authors.lastname: Biel
authors.affiliation: Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio.
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Auger
authors.affiliation: Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio.
authors.forename: Neera K
authors.initials: NK
authors.lastname: Goyal
authors.affiliation: Departments of Pediatrics, and Vanderbilt Center for Health Services Research, Nashville, Tennessee; Health Policy, and.
authors.forename: William O
authors.initials: WO
authors.lastname: Cooper
mesh_terms: D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay; D008297:Male; D015999:Multivariate Analysis; D009357:Neonatal Abstinence Syndrome / Q000628:therapy*; D010359:Patient Readmission / Q000706:statistics & numerical data*; D012189:Retrospective Studies