Rising drug-related infant mortality in the United States linked to COVID-19 pandemic

Infant deaths in which drugs were a primary or contributing factor increased more than twofold in the United States during the COVID-19 pandemic, a new study published in De Gruyter's Journal of Perinatal Medicine finds.

Despite recent alarming increases in drug overdose deaths in adults, drug-related deaths in infants remain understudied. Professor Panagiota Kitsantas of Florida Atlantic University and colleagues investigated drug-related infant mortality in the US immediately before the COVID-19 pandemic in 2018 to just after it in 2022. Drug-related deaths in infants can involve accidental ingestion of drugs, maternal drug use during pregnancy or, in some instances, even intentional poisoning of children with drugs.

Using the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (WONDER) database, the researchers found a total of 295 drug-related infant deaths recorded between 2018 and 2022. Strikingly, this represents a 2.2-fold increase in the number of such deaths, with the largest increase occurring between 2019 and 2022, and the largest proportion occurring in 2021. These deaths occurred mostly among post-neonatal infants who were aged between 28 and 364 days, with fewer occurring in neonates, aged 27 days or younger.

Many of the affected infants were born to non-Hispanic White (60.4%) and non-Hispanic Black mothers (28.5%). In non-Hispanic White mothers, the level of drug-related infant mortality (60.4%) exceeded all other causes of infant mortality (42.3%). In addition, a small majority of the infants affected were male (56.5%).

The COVID-19 pandemic likely played a large role in this phenomenon, with reduced access to prenatal care and hospital closures in rural areas. The adverse mental health impacts of the pandemic may also have contributed to changes in drug use. Overall maternal health, living conditions and economic status can also affect infant mortality, and these factors may also have played a role during the pandemic. The role of race/ethnicity suggests that particularly vulnerable communities should be addressed in any future interventions to help reduce these figures.

Given the alarming increase in the number of drug overdose deaths in the general population, especially among pregnant and postpartum women, it is critical to monitor drug-involved infant mortality in order to inform public health strategies and initiatives aimed at lowering these preventable deaths.

Effective strategies will require collaborative efforts among health providers, public health agencies, and community partners. These efforts should focus on preventing and treating maternal substance use disorders, enhancing prenatal care access, and addressing broader social and behavioral risk factors."

Professor Panagiota Kitsantas of Florida Atlantic University

Source:
Journal reference:

Kitsantas, P., et al. (2024). Increases in drug-related infant mortality in the United States. Journal of Perinatal Medicine. doi.org/10.1515/jpm-2024-0067.

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