Newborn congenital malformations associated with prenatal exposure to drugs in Kentucky, 2009-2013

Objectives This study examined associations between prenatal drug exposures and congenital organ system malformation diagnoses in newborns (at birth) and infants (hospitalizations after birth up to 30 days of age) in Kentucky. Methods Data were obtained from Kentucky inpatient hospitalization records for newborns and for infants from 2009 to 2013. Prenatal drug exposures and congenital anomalies were identified using International Classification of Diseases, Ninth Revision, Clinical Modification codes for prenatal drug exposures (760.70-760.79; 304; 779.5) and congenital anomalies (740-759). Descriptive analyses and logistic regression were performed. Results Neonatal abstinence syndrome was the most frequent prenatal drug exposure-related diagnosis in newborns (1%). Cardiac and circulatory malformation diagnoses were significantly elevated in newborns prenatally exposed to drugs compared with cardiac and circulatory malformation diagnoses in newborns with no prenatal drug exposures (P < 0.0001); genital and urinary anomalies also were significantly elevated among newborns with prenatal drug exposures (P < 0.05). Newborns and infants diagnosed as having congenital malformations who were prenatally exposed to drugs had significantly extended hospitalization stays and higher total hospitalization charges compared with newborns and infants diagnosed as having congenital malformations who were not prenatally exposed to drugs (P < 0.0001). Conclusions Further research is needed to identify specific risk factors (eg, drug classes, tobacco) and toxicities (eg, intake amount, frequency of intake, drug metabolism) associated with congenital malformation diagnoses following prenatal exposure to drugs.