Neonatal Abstinence Syndrome (NAS) is a condition when babies are exposed to certain drugs in the womb before birth. Drugs, such as pain medications (opioids) or stimulants (like cocaine or meth), can cause NAS.
When a baby is born, they are no longer getting the drug they used to get in the womb. This can cause withdrawal symptoms. Some examples of symptoms are:
- crying a lot,
- sleep problems,
- poor feeding,
- shaking,
- stiff muscles,
- diarrhea,
- fever, or
- seizures.
Not all babies with NAS will have the same symptoms.
Substance use during pregnancy is an important public health issue. It is key for people who can get pregnant to know the risks of using drugs during pregnancy. For more information, visit the CDC website on opioid use during pregnancy.
Help is available for people struggling with substance use. For help, call the SAMHSA National Helpline at 1-800-662-HELP (4537). MotherToBaby experts are available to answer questions about the risk of specific opioid medications used during pregnancy. For help, call 1-866-626-6847.
Neonatal abstinence syndrome (NAS) is when babies are exposed to certain drugs in the womb before birth.
Opioid use disorder (OUD) is chronic opioid misuse. This misuse can lead to harmful health outcomes. The use of opioids during pregnancy may cause NAS symptoms for the baby when they are born. OUD is a chronic condition, but treatment options are available.
General Fertility Rate is the number of live births per 1,000 females of childbearing age between the ages of 15-44 years.
Maternal Opioid-Related Diagnoses (MOD) Rate is the number of maternal opioid-related diagnoses per 1,000 delivery hospitalizations.
NAS: Counts and rates of infants born with Neonatal abstinence syndrome (NAS) based on inpatient hospitalization records were identified by ICD-9-CM diagnosis code 779.5 (drug withdrawal syndrome in newborn) and ICD-10-CM diagnosis code P96.1 (neonatal withdrawal symptoms from maternal use of drugs of addiction) present on the record for Virginia residents only. Data for 2016 and onward are based on ICD-10-CM.
Possible iatrogenic cases, identified by ICD-9-CM diagnosis codes 765.00-765.05, 770.7, 772.1x, 777.5x, 777.6 and 779.7, were excluded from the numerator. Birth hospitalizations were identified by ICD-9-CM diagnosis codes V30.xx-V39.xx, where the 4th and 5th digit is either 00, 01, 10 or 11, and ICD-10-CM diagnosis codes of Z38.00, Z38.01, Z38.1, Z38.2, Z38.30, Z38.31, Z38.4, Z38.5, Z38.61, Z38.62, Z38.63, Z38.64, Z38.65, Z38.66, Z38.68, Z38.69, Z38.7, or Z38.8. Those with an indication of transfer from another hospital were excluded to avoid duplication. NAS case data presented here are derived from data provided by Virginia Health Information (VHI) to the Virginia Department of Health (VDH) Office of Information Management (OIM).
NAS counts represented on this dashboard are not suppressed.
OUD: Opioid Use Disorder (OUD) counts and rates are based on inpatient hospitalization records were identified from diagnoses of opioid dependence and nondependent opioid abuse present on the record for Virginia residents only. OUD counts represented on this dashboard are not suppressed.
ICD-10-CM codes for Opioid Use Disorder (F11.20, F11.21, F11.220, F11.221, F11.222, F11.229, F11.23, F11.24, F11.250, F11.251, F11.259, F11.281, F11.282, F11.288, F11.29, F11.10, F11.120, F11.121, F11.122, F11.129, F11.14, F11.150, F11.151, F11.159, F11.181, F11.182, F11.188, F11.19). ICD-10-CM code for Long Term Use of Opioid Analgesics (Z79.891), and ICD-10-CM codes for Unspecified Opioid Use (F1190, F11920, F11921, F11922, F11929, F1193, F1194, F11950, F11951, F11959, F11981, F11982, F11988, F1199).
- Anbalagan, S., Falkowitz, D., & Mendez, M. (2024). Neonatal Abstinence Syndrome. StatPearls. National Library of Medicine, National Center for Biotechnology Information. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK551498/
- Association of State and Territorial Health Officials (ASTHO). Neonatal Abstinence Syndrome: How States Can Help Advance the Knowledge Base for Primary Prevention and Best Practices of Care. 2014. http://www.astho.org/prevention/nas-neonatal-abstinence-report/
- Haight SC, Ko JY, Tong VT, Bohm MK, Callaghan WM. Opioid Use Disorder Documented at Delivery Hospitalization — United States, 1999–2014. MMWR Morb Mortal Wkly Rep 2018;67:845–849. DOI: http://dx.doi.org/10.15585/mmwr.mm6731a1
- Ko JY, Wolicki S, Barfield WD, et al. CDC Grand Rounds: Public Health Strategies to Prevent Neonatal Abstinence Syndrome. MMWR Morb Mortal Wkly Rep 2017;66:242–245. DOI: http://dx.doi.org/10.15585/mmwr.mm6609a2
- Opioid Use During Pregnancy | CDC. (2019, July 1). Retrieved from https://www.cdc.gov/pregnancy/opioids/index.html.
- Patrick SW, Shumacher RE, Benneyworth BD et al. Neonatal Abstinence Syndrome and Associated Health Care Expenditures, 2000-2009. JAMA. 2012 May 9. 307(18):1934-40. http://jamanetwork.com/journals/jama/fullarticle/1151530
- Substance Use During Pregnancy | CDC. (2019, July 24). Retrieved from https://www.cdc.gov/reproductivehealth/maternalinfanthealth/substance-abuse/substance-abuse-during-pregnancy.htm.
For additional information about drug overdose and substance use, email overdose@vdh.virginia.gov.