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Maternal Substance Use and Neonatal Withdrawal

Substance use disorders (SUDs) during pregnancy contribute significantly to maternal morbidity and mortality in the United States. In Nebraska (NE), SUDs contributed to one in five pregnancy-associated deaths between 2017-2021. In their most recent report (2023), the NE Maternal Mortality Review Committee (MMRC) recommended substance use disorder screening, referral, and plan of safe care and substance abuse identification, treatment, and follow-up as actionable strategies to reduce preventable maternal mortality.  

Maternal Infant Health Opioid Use

This infographic is a publication of the Centers for Disease Control and Prevention (CDC). November, 2022. 

Opioid exposure in pregnancy is an increasingly common problem in the United States, and in Nebraska there is a large amount of variability with maternal opioid use. NPQICs unpublished data highlights the impact of education to the healthcare profession in decreasing prescriptions of opioids and increasing diagnoses of infants with Neonatal Opioid Withdrawal Syndrome (NOWS) when they have exposures. We know that early diagnosis of a newborn prior to leaving the hospital decreases mortality in this high risk population. 

NPQICs Maternal Infant Health Opioid Project has two main objectives. The first is to provide education to health care providers and medication dispensaries regarding opioid prescription use in pregnancy, and the second is to help develop, enhance, and strengthen the ability of primary care providers to implement therapeutic interventions that can improve the health outcomes of families affected by prenatal opioid exposure. 

NPQIC has partnered with the Academy of Pediatrics (AAP) and created an ECHO series that aims at supporting pediatric primary care practices by raising awareness of infants with prenatal opioid exposure (i.e., documented birth history) and family-focused anticipatory guidance based upon developmental surveillance and screening. 



Project Resources

Opioid Use Disorders: Interventions for Community Pharmacists

CDC Training for Healthcare Professionals: 2022 CDC Clinical Practice Guideline for Prescribing Opioids for Pain

Illinois Perinatal Quality Collaborative: Mother and Newborns Affected by Opioids SBIRT Simulations Guide

NPQIC Opioid Prescriptions in Pregnancy Webinar Handout (3/2023)

NEW RESEARCH NEJM: Eat, Sleep, Console Approach or Usual Care for Neonatal Opioid Withdrawal (4/2023)

This infographic is a publication of the Centers for Disease Control and Prevention (CDC). November, 2022. 

Opioids in Pregnancy Posters

Provider Poster

Pharmacy Poster

Substance Use Disorder Webinar Series

  • Session 1: CAPTA, CARA, and NE Plan of Safe Care (4/22/24)
    • Available for 1.0 CME, DEA MATE, and Opioid Prescriber Credit until April 22nd, 2026

NPQIC/AAP Maternal Infant Health Opioid Use ECHO Series:

  • Session 1: Neonatal Opioid Withdrawal Syndrome (NOWS) and the Eat Sleep Console (ESC) Model
  • Session 2: Opioid Epidemic and the Pediatric Population
  • Session 3: NOWS and Stigma: What is a Substance of "No-Choice”
  • Session 4: The Role of CPS and the Hotline
  • Session 5: Plans of Safe Care
  • Session 6: Newborns with NOWS: Care After Discharge