Identification of Prenatal Opioid Exposure Within Health Administrative Databases

BACKGROUND: Health administrative data offer a vital source of on maternal prenatal opioid exposure (POE). The impact different methods to estimate POE, especially combining and newborn records, is not known. METHODS: This population-based cross-sectional study included 454 746 hospital births with linked in Ontario, Canada, 2014–2017. POE ascertainment 3 sources: (1) prescriptions, (2) opioid-related (3) records neonatal abstinence syndrome (NAS). Positive percent agreement was calculated comparing cases identified by source, comprehensive method developed all sources. We replicated common definitions NAS from existing literature compared both number ascertained socio-demographics medical history using the method. RESULTS: Using sources, there were 9624 (21.2 per 1000 births). Among these, positive (95% confidence interval) 79.0% (78.2–79.8) for 19.0% (18.2–19.8) 44.7% (43.7–45.7) NAS. Compared other definitions, our up 523% additional cases. Contrasting NAS, prescriptions respective rates low income 57%, 48%, 39%; mental health hospitalization 33%, 28%, 17%; infant discharge social services 8%, 13%, 5%. CONCLUSIONS: Combining codes improves identification broader population mothers infants POE.