Improve Neonatal Outcomes

The Neonatal Subcommittee has been working to unify care practices and improve outcomes for babies born with Neonatal Abstinence Syndrome (NAS) in the State of Utah. NAS is a group of signs and symptoms exhibited by a baby after birth when he/she withdraws from opioid exposure while inside the mother’s womb. In addition to opioid exposure, many babies are exposed to other illicit substances (such as methamphetamine or marijuana) and/or other prescribed medications (such as anti-depressant or anti-anxiety medications) that may worsen the signs/symptoms of NAS.

The subcommittee has created and implemented evaluation and treatment guidelines in nine out of the ten UWNQC participating hospitals which represent over 56% of births in Utah. The evaluation guideline provides guidance on the length of observation post-delivery depending on the substances exposed such that each baby is monitored for the development of withdrawal signs/symptoms and is properly followed up post-discharge. The treatment guideline uses the Neonatal Withdrawal Inventory (NWI) scoring tool which incorporates the baby’s routine cares into the scoring to assess the baby’s withdrawal severity. Non-pharmacological maneuvers such as low lighting, swaddling, and reducing excessive environmental stimuli are touted as first line therapy for all babies with NAS. Pharmacological treatment with morphine and adjunctive medications is reserved for babies with moderate to severe withdrawal.

The educational materials for providers who wish to implement our evaluation and treatment guidelines are available below, including: Strategies to Improve Care for Infants with Neonatal Drug Withdrawal–A Resource Guide for Utah Practitioners.

The Neonatal Subcommittee has also added Illicit and Prescription Drug Variables to the Utah Birth Certificate registry since January 2016 in order to understand the prevalence of such use in pregnant women in the State of Utah.

As of January 1, 2014, the Utah Division of Occupational and Professional Licensing (DOPL) has mandated that all Utah-licensed practitioners take at least four continuing education hours per licensing period on controlled substance prescription. The Neonatal Subcommittee within UWNQC provided partial financial support to the University of Utah CME-sponsored opioid education course entitled, “The Opidemic: Our role in curbing this devastation.” Over 1,200 Utah-licensed practitioners have taken this course for their 2018-2020 licensing period.

Neonatal Abstinence Syndrome Resources

The Committee added Prescription Drug Variables to the Utah Birth Certificate.  Below shows women who self-reported opioid illicit drug use during pregnancy.