The number of infants exposed to opioids during pregnancy in the United States has increased by 333% in the past two decades.  Every 15 minutes, a baby is born exposed to opioids or one newborn every 15 minutes.  These infants are at high risk for developing Neonatal Opioid Withdrawal Syndrome (NOWS) - the drug withdrawal syndrome that occurs due to the abrupt discontinuation of prenatal opioids following delivery. These infants can be difficult to manage, are often kept in the hospital for prolonged periods of time, separated from their mothers with  an annual cost of $2.5 billion.

In one study, “Clinical markers of neonatal opioid withdrawal syndrome: onset, severity and longitudinal neurodevelopmental outcome” funded by a grant from the NIH National Institute on Drug Abuse (Dr. Lester, Principle Investigator) the objective is to identify predictors of NOWS and chart the neurodevelopmental outcome of newborns with NOWS. We will study over 300 infants at Women and Infants Hospital and at the University of Utah in the newborn period and at 6 and 18 months. Using measures of neurobehavior, cry analysis, analysis of hair for prenatal drug use, epigenetics and sociodemographic characteristics we will develop algorithms to predict which individual infants will develop NOWS and the severity of NOWS. Our goal is to detect which individual newborns could be discharged early and which newborns to target for treatment to reduce NOWS severity. This could lead to the development of tools that will allow clinicians to intervene early, improve care for these infants and improve their long-term developmental outcomes.

The second study is “Monitoring newborn sleep to improve treatment and outcomes from opioid exposure” funded by an NIH COBRE (Center of Biomedical Research and Excellence) grant (Dr. Salisbury, Principle Investigator). In this study we will measure newborn sleep state and respiration patterns before, during and after withdrawal (NOWS) in opioid exposed newborns. Poor sleep is used in the diagnosis of NOWS. Measurement of sleep state organization is also a biomarker of brain function and a predictor of long-term outcomes.  The goals of this study are to: 1). improve the accuracy of the measurement of NOWS that will lead to a more accurate diagnosis as well as indicators for treatment initiation, 2) understand the relative effects of treatments for maternal opioid use disorders in pregnancy, and 3) understand the relative effects of NOWS treatment on brain development.