Journal Logo

In the News

Rural Pregnant Women and Newborns Hit Hard by Opioid Crisis

Stockwell, Serena

Author Information
AJN, American Journal of Nursing: March 2017 - Volume 117 - Issue 3 - p 17
doi: 10.1097/01.NAJ.0000513278.76259.6d
  • Free


Another unfortunate sign of the opioid crisis: more pregnant women in rural areas are using the drugs, and there has been a disproportionately higher increase in neonatal abstinence syndrome (NAS; also known as neonatal withdrawal syndrome) in rural compared with urban areas. The first national study of such trends used data from the Agency for Healthcare Research and Quality's National Inpatient Sample of births and deliveries between 2004 and 2013.

The proportion of newborns with NAS in rural parts of the country increased from 12.9% to 21.2% during that time. The incidence of NAS per 1,000 births in hospitals increased from 1.2 to 7.5 in rural areas compared with 1.4 to 4.8 in cities. The frequency of hospital deliveries related to maternal opioid use increased from 1.3 to 8.1 per 1,000 deliveries in rural areas compared with 1.6 to 4.8 in urban areas.

The geographic disparity is especially troubling because rural areas are much less likely to have resources to deal with the problems, the researchers said.

The recent signing into law of the Comprehensive Addiction and Recovery Act (CARA), however, offers hope, according to the study's lead author, Nicole Villapiano, a pediatrician at C.S. Mott Children's Hospital at the University of Michigan in Ann Arbor: “CARA promotes creation of an opioid abuse grant program with emphasis on getting funding to rural areas hardest hit by the opioid crisis,” she told AJN. “The law also includes provisions specifically aimed at improving access to treatment for pregnant women using opioids.” —Serena Stockwell


Villapiano NL, et al JAMA Pediatr Dec 12, 2016 [Epub ahead of print].
    Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.