(426) Impact of NICU length of stay on outcomes of birthing people with opioid use disorder

To determine the impact of NICU length of stay on health outcomes of birthing people with opioid use disorder (OUD). Primary outcome was EDPS and GAD-7 scores.


Study Design: Longitudinal prospective cohort of pregnant persons receiving care through a comprehensive perinatal substance use treatment program between 2014 and June 2024. Characteristics of every patient who participated in the program were analyzed regardless of prenatal program participation or complete delivery outcome information; a minimum of p</span>ostpartum program participation and neonatal outcomes were required for inclusion in the study. Participants were divided into groups based on whether their infant stayed more or fewer than 15 days in the NICU. Fisher's exact and two-sample t-tests were utilized for statistical analysis.

Results: There was no significant difference in postpartum EDPS and GAD-7 scores when groups were analyzed by infant’s duration of stay in the NICU (<15 days, n=183 or 15+ days, n=106). However, EPDS score >13 at weeks 11 – 15 postpartum was observed in 33% of patients with infant NICU stays >15 days as compared to 0% with shorter stays, though this was not statistically significant (p=0.4667). Birthing parents of infants who stayed < 15 days in the NICU were more likely to be exclusively breastfeeding at time of discharge (38.1% vs 32.6%, p=0.0331) and room in with their infant (70.6% vs 47.1%, p=0.001). There was no significant difference in attendance at postpartum visits (74% vs 72%, p=0.6106).

Conclusion: When stratified at the 15-day mark, duration of infant’s NICU stay did not appear to be associated with any significant difference in birthing parents’ EDPS or GAD-7 scores. However, 33% of parents experienced an EPDS score suggestive of depression as compared to 0% in the shorter stay group. Further studies are needed to evaluate the mental health of parents when their neonate has an extended hospital stay for neonatal opioid withdrawal syndrome (NOWS). Breastfeeding and rooming-in are strategies associated with shorter stays for NOWS, which our study also found.