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United States Value:
Number of birth hospitalizations with a diagnosis code of neonatal abstinence syndrome (withdrawal symptoms due to prenatal exposure to illicit drugs) per 1,000 birth hospitalizations
Number of birth hospitalizations with a diagnosis code of neonatal abstinence syndrome (withdrawal symptoms due to prenatal exposure to illicit drugs) per 1,000 birth hospitalizations in large metropolitan areas
1.6 - 2.9
3.0 - 4.7
4.8 - 5.6
5.7 - 6.8
6.9 - 10.9
No Data
US Value: 5.3
Top State(s): Hawaii: 1.0
Bottom State(s): West Virginia: 31.9
Definition: Number of birth hospitalizations with a diagnosis code of neonatal abstinence syndrome (withdrawal symptoms due to prenatal exposure to illicit drugs) per 1,000 birth hospitalizations
Data Source and Years(s): U.S. DHHS, AHRQ, Healthcare Cost and Utilization Project, State Inpatient Database via Health Resources and Services Administration, Maternal and Child Health Bureau, Federally Available Data (FAD) Resource Document, 2022
Suggested Citation: America's Health Rankings analysis of U.S. DHHS, AHRQ, Healthcare Cost and Utilization Project, State Inpatient Database via Health Resources and Services Administration, Maternal and Child Health Bureau, Federally Available Data (FAD) Resource Document, United Health Foundation, AmericasHealthRankings.org, accessed 2026.
Neonatal abstinence syndrome (NAS) is a drug withdrawal syndrome occurring in newborns. NAS is most commonly caused by fetal exposure to maternal opioid use, and is also associated with benzodiazepine, barbiturate and alcohol use. Data linking NAS with other maternal drug use is inconclusive, but use of chemically addictive substances during pregnancy — including selective serotonin reuptake inhibitor (SSRI) antidepressants — can cause symptoms characteristic of withdrawal in newborns. Between 55% and 94% of infants exposed to opioids during gestation experience withdrawal symptoms. Opioid use during pregnancy has increased in the United States over the last 20 years, with corresponding increases in NAS.
Symptoms of NAS can include tremors, increased muscle tone, high-pitched crying, seizures, feeding difficulties, low birth weight and temperature instability. NAS can cause long-term symptoms in children as well, such as developmental delays, growth problems and hearing and vision problems.
Newborns with NAS stay in the hospital an average of 1.8 days longer than newborns without NAS, which is associated with an increased hospital cost of $1,685 per day. Medicaid covered 82% of NAS-related births in 2014, costing the U.S. $462 million. Furthermore, the long-term health care costs of infants diagnosed with NAS within 30 days of birth are approximately $17,900 higher than those without NAS.
According to America’s Health Rankings analysis, the prevalence of neonatal abstinence syndrome is higher among:
Preventing and treating maternal opioid dependence before and during pregnancy is crucial to reducing cases of NAS. Strategies include:
Mandated reporting of NAS cases in hospitals helps guide programs and services with consistent and reliable data on NAS incidence, trends and associated factors. Reporting can also help identify more cases of maternal opioid use disorder, improving data critical to developing effective interventions.
The American College of Obstetricians and Gynecologists has several recommendations regarding opioid use during pregnancy, including:
Healthy People 2030 has multiple goals relating to neonatal abstinence syndrome, including increasing abstinence from illicit drugs among pregnant women and reducing the proportion of women who use illicit opioids during pregnancy.
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