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 participating hospitals.

“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 withdrawal symptoms.”

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 testing.