Seven hospitals in Greater Cincinnati will begin universal
drug testing on all expectant mothers beginning September 1.
The new approach to drug screening is one part of a
coordinated response to a surge of drug-addicted infants born in the region.
The number of babies in the area who were exposed in the
womb to Percocet, methadone, heroin and other opioids has quadrupled in about
four years -- from 10.8 infants per 1,000 births in 2009 to 46 per 1,000 births
in the first three months of 2013. These infants typically require extended
hospital stays for observation, and many need medical treatment for neonatal
abstinence syndrome (NAS).
The new testing policy was developed by a group of hospitals
working with the Greater Cincinnati Health Council. Cincinnati Children’s,
which provides neonatology services to nearly all maternity units in the
region, coordinated research that supports the new policy. Cincinnati
Children’s also led efforts to develop a standardized treatment algorithm for NAS to be used by
“Testing is designed to help the family, the mother and the
infant,” says Scott Wexelblatt, MD, medical director of regional newborn services at Cincinnati
Children’s. “It enables us to ensure that the hospital can monitor the infant
after birth and provide the appropriate care if the infant begins to show
In March 2012, Ohio Gov. John Kasich announced the state would provide $1 million to help Ohio’s children’s hospitals analyze the number and types of drug exposures
affecting newborns. In May 2013, Wexelblatt discussed the rising numbers
of infants with NAS in detail during a Grand Rounds presentation at Cincinnati Children’s.
In addition to harming children, the surge in drug-exposed
infants creates a healthcare burden, Wexelblatt says. In Ohio, the average length
of stay in 16.4 days for an infant suffering from opiate withdrawal compared
with 3.3 days for infants without NAS. The average cost of a hospital stay for
NAS is about $53,400 compared to $9,500 for infants without NAS.
Hospitals participating in the new drug testing policy include
Cincinnati Children’s, University of Cincinnati Medical Center, Bethesda North
Hospital, Good Samaritan Hospital, Mercy Health Anderson, Mercy Health
Fairfield and St. Elizabeth.
The drug testing will become standard procedure for the
hospitals but is not mandatory for individuals; any patient can refuse the
test. Even so, the testing is expected to detect drug-exposed newborns who otherwise
might be sent home before NAS symptoms emerge.
In pilot research, Wexelblatt says as many as 20 percent of infants
exposed to opioids who were detected by universal screening would not have been
detected by existing hospital practices and procedures. Likewise, 33 percent of
infants exposed to other drugs would not have been detected without universal