These data are reported by birthing hospitals that participate in the Perinatal Substance Use Hospital Collaborative. Substance exposure is measured through laboratory testing of infant umbilical cords. Participating hospitals utilize their own protocols and algorithms to determine when to test an umbilical cord for substances and that process is heavily dependent on the care provider's experience and hospital protocol.

These data do not represent every birthing hospital in the state and do not represent all babies born in the state. Instead, the data only represent participating hospitals. Changes over time in these statistics can also be a result of changes in the number of hospitals that participate in the collaborative and submit data, rather than a true change in the rate of Neonatal Abstinence Syndrome (NAS).

The hospital collaborative defines NAS as in utero exposure to opioids with or without other substances and any two of the following five clinical signs which are characteristic of substance withdrawal: 

• Excessive Crying (easily irritable)
• Fragmented sleep (< 2-3 hours after feeding)
• Tremors (disturbed or undisturbed)
• Increased muscle tone (stiff muscles)
• Gastrointestinal dysfunction (hyperphagia, poor feeding, feeding intolerance, loose or watery stools)

Community health workers participating in the CARE Plus program work to build relationships with mothers and caregivers in hopes of helping them navigate some of these challenges and provide them with the resources they need—whether it’s health care, housing, food, or other social services, as well as helping new mothers find treatment and therapy for opioid dependence. 

Source: https://medicine.iu.edu/expertise/indiana-health/opioid-crisis/neonatal-abstinence-syndrome. Last accessed 4/8/2024. 

Providing support to new moms after they leave the hospital with a new baby who has had neonatal abstinence syndrome is challenging. These women usually need to find new caregivers depending on their health needs, and many treatment programs for substance addictions do not accommodate a mother and baby pair. It can also be difficult for mothers to focus on their own recovery process while learning to care for a newborn with neonatal abstinence syndrome.

Source: https://medicine.iu.edu/expertise/indiana-health/opioid-crisis/neonatal-abstinence-syndrome. Last accessed 4/8/2024.

These data are provided by the birthing hospitals that participate in the Perinatal Substance Use Hospital Collaborative. Each hospital submits key metrics into a redcap database which the Indiana Department of Health Maternal & Child Health Division can access and analyze for reporting purposes.