Five-Year Outcomes Among Medicaid-Enrolled Children With In Utero Opioid Exposure

Published in: Health Affairs, Volume 39, No. 2 (February 2020). doi: 10.1377/hlthaff.2019.00740

Posted on RAND.org on February 06, 2020

by Marian P. Jarlenski, Elizabeth E. Krans, Joo Yeon Kim, Julie M Donohue, A. Everette James, David Kelley, Bradley D. Stein, Debra L. Bogen

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The health of women and children affected by opioid use disorder is a priority for state Medicaid programs. Little is known about longer-term outcomes among Medicaid-enrolled children exposed to opioids in utero. We examined well-child visit use and diagnoses of pediatric complex chronic conditions in the first five years of life among children with opioid exposure, tobacco exposure, or neither exposure in utero. The sample consisted of 82,329 maternal-child dyads in the Pennsylvania Medicaid program in which the children were born in the period 2008–11 and followed up for five years. Children with in utero opioid exposure had a lower predicted probability of recommended well-child visit use at age fifteen months (42.1 percent) compared to those with tobacco exposure (54.1 percent) and those with neither exposure(55.7 percent). Children with in utero opioid exposure had a predicted probability of being diagnosed with a pediatric complex chronic condition similar to that among children with tobacco exposure and those with neither exposure (20.4 percent, 18.7 percent, and 20.2 percent,respectively). Our findings were consistent when we examined a subgroup of opioid-exposed children identified as having neonatal opioid withdrawal symptoms.

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