Elucidating the Relationship Between Maternal Diabetes and Neonatal Abstinence Syndrome: A 2017-2018 Project WATCH Study in Rural Appalachia

Adv Neonatal Care. 2022 Jun 1;22(3):239-245. doi: 10.1097/ANC.0000000000000897. Epub 2021 Jun 16.

Abstract

Background: Previous research indicated that diabetes during pregnancy results in a more permeable placenta. Based on this data, we hypothesized that women with maternal diabetes were more likely to have infants who developed neonatal abstinence syndrome (NAS).

Purpose: The purpose of the study was to examine the association between maternal diabetes and NAS in a cohort of women reporting substance use during pregnancy.

Methods: This study used data from a population-based cohort of all newborns born in 2017 and 2018 (N = 36,974) in the state of West Virginia and restricted the analysis to those infants with intrauterine substance exposure (14%, n = 5188). Multiple logistic regression was performed to analyze the adjusted relationship between maternal diabetes and NAS while controlling for maternal and infant covariates.

Results: Just over 28% of women with diabetes had an infant who developed NAS, whereas 34.8% of women without diabetes had an infant who developed NAS. The adjusted odds ratio of infants developing NAS born to women with diabetes was 0.70 (95% confidence interval: 0.51, 0.94) compared with those born to mothers without diabetes after controlling for covariates. Contrary to our hypothesis, the study suggests that maternal diabetes during pregnancy is associated with a decreased risk of an infant developing NAS.

Implications for practice: Future research generating from this hypothesis may lead to potential implications for practice for infants born to mothers with substance use during pregnancy and diabetes.

Implications for research: More research should be conducted to investigate the relationship between glucose metabolism and NAS.

MeSH terms

  • Appalachian Region / epidemiology
  • Child, Preschool
  • Cohort Studies
  • Diabetes Mellitus* / epidemiology
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Mothers
  • Neonatal Abstinence Syndrome* / epidemiology
  • Opioid-Related Disorders*
  • Pregnancy
  • Pregnancy Complications*
  • Retrospective Studies
  • Substance-Related Disorders* / complications
  • Substance-Related Disorders* / epidemiology