P3.F120: Tale of Two Adjacent Counties: NAS Trends in Northeast TN

Background: Neonatal Abstinence Syndrome (NAS) is a growing concern in the United States, characterized by newborns experiencing withdrawal symptoms from drugs, notably opioids, used during pregnancy. NAS poses risks such as low birth weight and prolonged hospitalization. In Tennessee, NAS incidence has surged tenfold since the early 2000s, prompting its designation as a reportable condition by the Tennessee Department of Health (TDH) in 2013. Our study focuses on NAS trends in two Tennessee regions, the Northeast and Sullivan counties, both known for high opioid use rates.

Methods: This study made use of publicly accessible data retrieved from sources including the TDH and the Kids Count Data Center. Data included rate of occurrence of NAS and number of cases for the two regions for the years 2017 to 2022. Regression analysis was performed to compare the trend in NAS rates over the years between the two counties. All analyses were conducted using SAS version 9.4.

Results: In Northeast, 40.7% of cases involved prescription medication use, 34.1% a combination of prescriptions and illicit drugs, and 23.1% illicit drugs alone. Sullivan exhibited different proportions: 39.2% prescription medications only, 16.2% a combination of prescriptions and illicit drugs, and 44.6% illicit drugs alone. The regression analyses revealed distinct trends in disease rates over time for Northeast and Sullivan counties. In Northeast, a significant regression model (p = 0.0105) demonstrated a substantial decrease in rates (coefficient = -10.94543), explaining 83.77% of rate variability (R-squared = 0.8377). Conversely, Sullivan showed an insignificant model (p = 0.9110) with a negligible rate decrease (coefficient = -0.17314), explaining minimal variability (R-squared = 0.0035). These findings indicate a notable decreasing trend in Northeast rates, contrasting with Sullivan's lack of significant trend.

Conclusion: Our study highlights the contrasting trends in neonatal abstinence syndrome (NAS) occurrence between Tennessee's Northeast region and Sullivan County, reflecting regional variability in NAS dynamics and substance use patterns during pregnancy. While the Northeast exhibited a significant decreasing trend in NAS rates, Sullivan showed no significant trend. These findings underscore the need for targeted interventions addressing adjacent regional disparities in substance use and maternal health to mitigate NAS's impact on newborns and families. Comprehensive strategies informed by ongoing surveillance and research efforts are crucial to combatting NAS and improving outcomes across diverse regional contexts.