OBJECTIVES : To assess the incidence rate, clinical characteristics and healthcare resource utilization associated with neonatal abstinence syndrome (NAS).

METHODS : Texas Inpatient Public Use Data Files (TIPUDF) from 2006 to 2017 were used to identify cases of NAS based on type of admission and International Classifications of Diseases Codes from the 9^th and 10^th revisions. Incidence rate was calculated as number of NAS cases per 1,000 hospital births for each calendar year. Demographic and clinical characteristics of NAS admissions were analyzed and compared to all other birth-related hospitalizations (control). Statistical difference between NAS and control cases were tested using Chi-squared tests for categorical variables and t-test for continuous variables.

RESULTS : The study found NAS incidence rate increased from 0.99 to 2.36 per 1,000 hospital births in Texas from 2006 to 2015. There were strong associations (p<0.001) of NAS cases with white race, male sex, non-Hispanic ethnicity, and Medicaid insurance. Clinical conditions such as jaundice, seizures, feeding difficulties, respiratory problems, underweight newborns and sepsis were found to be more prevalent in NAS cases. Overall, NAS cases were found to be associated with significantly longer length-of-stay (22.2 days) compared to the control (3.5 days) and significantly higher charges ($102,761) compared to the control ($15,492).

CONCLUSIONS : NAS incidence have increased in the last 10 years. Resources needs to be allocated to early detection, treatment and follow-up care for newborns with NAS.