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Multilevel factors associated with length of stay for neonatal abstinence syndrome in Florida’s NICUs: 2010–2015

Journal of Perinatology volume 41, pages 1389–1396 (2021)Cite this article

Subjects

Abstract

Objective

To investigate potential factors influencing initial length of hospital stay (LOS) for infants with neonatal abstinence syndrome (NAS) in Florida.

Methods

The study population included 2984 term, singleton live births in 33 Florida hospitals. We used hierarchical linear modeling to evaluate the association of community, hospital, and individual factors with LOS.

Results

The average LOS of infants diagnosed with NAS varied significantly across hospitals. Individual-level factors associated with increased LOS for NAS included event year (P < 0.001), gestational age at birth (P < 0.001), maternal age (P = 0.002), maternal race and ethnicity (P < 0.001), maternal education (P = 0.032), and prenatal care adequacy (P < 0.001). Average annual hospital NAS volume (P = 0.022) was a significant hospital factor.

Conclusion

NAS varies widely across hospitals in Florida. In addition to focusing on treatment regimens, to reduce LOS, public health and quality improvement initiatives should identify and adopt strategies that can minimize the prevalence and impact of these contributing factors.

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Fig. 1: Flow diagram of infants with NAS included in the study.
Fig. 2: Variability of neonatal abstinence syndrome length of stay by hospitals in Florida: 2010–2015.
Fig. 3: Length of stay for neonatal abstinence syndrome by birth year.

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Funding

This study was partially supported by a contract from the Florida Department of Health.

Author information

Authors and Affiliations

  1. College of Public Health, University of South Florida, Tampa, FL, USA

    Chinyere N. Reid, Tara R. Foti, Alfred K. Mbah, Maya Balakrishnan, Russell S. Kirby, Roneé E. Wilson & William M. Sappenfield

  2. Chiles Center, College of Public Health, University of South Florida, Tampa, FL, USA

    Chinyere N. Reid, Tara R. Foti, Russell S. Kirby, Roneé E. Wilson & William M. Sappenfield

  3. Department of Pediatrics, University of Florida College of Medicine-Jacksonville, Jacksonville, FL, USA

    Mark L. Hudak

Authors
  1. Chinyere N. Reid
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  2. Tara R. Foti
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  3. Alfred K. Mbah
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  4. Mark L. Hudak
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  5. Maya Balakrishnan
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  6. Russell S. Kirby
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  7. Roneé E. Wilson
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  8. William M. Sappenfield
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Contributions

All authors conceptualized and designed the study. CNR, and TRF conducted data analysis. CNR drafted the initial manuscript and received critical input from TRF, AKM, MLH, MB, RSK, REW, and WMS in the final manuscript.

Corresponding author

Correspondence to Chinyere N. Reid.

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The authors declare that they have no conflict of interest.

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Reid, C.N., Foti, T.R., Mbah, A.K. et al. Multilevel factors associated with length of stay for neonatal abstinence syndrome in Florida’s NICUs: 2010–2015. J Perinatol 41, 1389–1396 (2021). https://doi.org/10.1038/s41372-020-00815-8

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