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Introduction: Prenatal exposure to addictive substances is an important public health concern with potential consequences for neonatal health and early brain development. Maternal substance use during pregnancy has been associated with adverse birth outcomes and increased healthcare utilization in the neonatal period. These risks may be further amplified among Medicaid populations that experience persistent healthcare disparities. Understanding early indicators of neonatal instability may help identify infants at elevated risk for neurodevelopmental complications. This study examines the association between maternal substance use and neonatal intensive care unit (NICU) utilization and transitions in level of care (LOC) among infants born to Medicaid beneficiaries. Methods: A hybrid data linkage approach was used to integrate Nevada Birth Registry and Medicaid Claims datasets from 2015–2021, achieving approximately 85% linkage efficiency. Infant hospitalization records were analyzed using descriptive, univariate, and bivariate statistical methods to explore associations between maternal substance use and neonatal LOC admissions and transitions. NICU care transitions were evaluated as indicators of neonatal clinical instability that may reflect increased neurodevelopmental vulnerability. Statistical significance was set at p < 0.05. Results (Preliminary): Preliminary analyses identified 84,181 linked infant records. Of these, 70,817 (84.1%) infants remained in a single LOC during hospitalization, while 13,364 (15.9%) experienced multiple LOC transitions. Early findings suggest that infants with multiple LOC transitions were more likely to be born to mothers reporting substance use, including tobacco, cigarette smoking, illicit drug use, and prescription drug misuse. Initial analyses also indicate that a subset of infants required higher-level NICU care. Additional multivariable analyses examining patterns of substance exposure and neonatal outcomes are currently underway. Conclusion: Preliminary findings suggest that prenatal substance exposure may be associated with increased neonatal care needs and greater clinical instability in the early postnatal period. These patterns may represent early indicators of neurodevelopmental vulnerability among substance-exposed infants. Ongoing analyses will further clarify these relationships and inform early identification and intervention strategies aimed at improving long-term neurodevelopmental outcomes for mother-infant dyads.

Publisher Location

Las Vegas (Nev.)

Publication Date

Spring 4-17-2026

Publisher

University of Nevada, Las Vegas

Language

English

Keywords

Prenatal; NICU; Transitions; MCH; Addiction

Disciplines

Maternal, Child Health and Neonatal Nursing | Medicine and Health Sciences | Nursing

File Format

PDF

File Size

646 KB

Comments

Mentor: Kavita Batra

Rights

IN COPYRIGHT. For more information about this rights statement, please visit http://rightsstatements.org/vocab/InC/1.0/

NURTURE Study: Neonatal Utilization and Risk from Maternal Substance Exposure- Transitions, Resource Needs, and Outcomes


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