PULLMAN, WA – Most babies born with prenatal exposure to drugs show signs of withdrawal, a spectrum of symptoms that’s called neonatal abstinence syndrome.
This hidden epidemic affects babies in Spokane County at a greater rate than in the state or in the nation, according to a report prepared by Washington State University Health Sciences.
“The numbers were quite high,” said Ekaterina Burduli, associate professor at the WSU Elson S. Floyd College of Medicine and the study’s lead author.
The prevalence of NAS per 1,000 live hospital births was 21.1 in Spokane County in 2022, according to the Washington State Department of Health. That same year the rate in Washington was 11.2. Nationally the rate of NAS was 6.2 per 1,000 live births in 2021.
“Of note, the Washington rate has also increased year-over-year from 2019 to 2022 while the national rate of NAS has remained stable,” the report said.
The prevalence of neonatal abstinence syndrome per 1,000 live hospital births was 21.1 in Spokane County in 2022, according to the Washington State Department of Health. That same year the rate in Washington was 11.2. Nationally the rate of NAS was 6.2 per 1,000 live births in 2021.
Last year WSU Health Sciences was asked by the Washington Health Care Authority to look at health outcomes at Maddie’s Place in Spokane, one of two recovery nurseries in the state that provide withdrawal care to infants. The report was released earlier this year.
The 71 infants whose information was included in the study were exposed to an average of four substances at birth. The most common were methamphetamines, followed by fentanyl. Being exposed to multiple substances, and to fentanyl in particular, complicates care of infants with NAS, the report noted.
“Some of the protocols for managing infant withdrawal are not as effective for infants exposed to fentanyl and other substances simultaneously,” requiring longer courses of treatment. The average stay at Maddie’s Place for the infants involved in the study was 56 days.
Nearly 80 percent of the mothers involved in the study were considered homeless when their babies were admitted to Maddie’s Place. Burduli said that’s another complicating factor when it comes to health outcomes.
“It’s a huge barrier,” she said. “Caring for babies is the goal of Maddie’s Place, but once they opened up (in late 2022) and started caring for families, they realized that to help babies thrive they needed to invest in the mother and the family.” Maddie’s Place helps mothers and families get on waiting lists for safe, affordable housing, or to be discharged into other stable environments.
“Maddie’s Place is a real safety net for the most vulnerable families in our community,” Burduli said.
The Washington Legislature, which requested the study, asked specifically whether Maddie’s Place could prevent more costly medical interventions like hospitalization. The study was unable to conclude that because there was no comparison group or formal analysis. However, it said any replacement of days infants would otherwise spend in neonatal intensive care could be considered cost-effective.
Finally, the study asked parents about their experiences during pregnancy and after giving birth. Of the 15 mothers who agreed to answer questions, all were positive about Maddie’s Place.
Without Maddie’s Place, “I would probably still be using and I probably wouldn’t have my kid,” said one mother.
Said another, “Really just like anything we’ve needed and asked for, they’ve met our needs, which is amazing. It makes it that much easier to keep you in the right mind frame and doing the next right thing instead of like falling back into that cycle and giving up.”
The study suggested follow-up work to monitor the health and development of infants served at Maddie’s Place, among other recommendations.
With continued state funding a question mark, however, “there are a lot of questions people have about effectiveness that we can’t answer unless it stays in business,” Burduli said.