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MEDNAX Study of Neonatal Abstinence Syndrome Published in New England Journal of Medicine

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MEDNAX, Inc. (NYSE:MD) announced that a study of the increase in admissions to the neonatal intensive care unit (NICU) related to neonatal abstinence syndrome (NAS) has been published online in the New England Journal of Medicine.

NAS is a drug withdrawal syndrome that most commonly occurs after in utero exposure to opioids. From 2000 to 2009, the incidence of NAS in the United States nearly tripled, according to an article published in the Journal of the American Medical Association in 2012, concurrent with growth in the use of opioids by pregnant women.

Despite these increases, no study had yet evaluated changes in NICU utilization or management of infants with the syndrome. The study published by the NEJM, titled “Increasing Incidence of the Neonatal Abstinence Syndrome in U.S. Neonatal ICUs,” directly addresses this topic, relying on data from MEDNAX’s Clinical Data Warehouse, and found that NAS is responsible for a substantial and growing portion of resources dedicated to critically ill neonates in NICUs nationwide.

“This study highlights one of the most critical issues in neonatal medicine today, namely the increasing exposure of the fetus to narcotic drugs,” said Alan Spitzer, M.D., Senior Vice President for Research, Education and Quality at MEDNAX. “The rapidly rising rate of NICU admissions for neonates who are withdrawing from narcotic exposure during pregnancy is alarming and, most importantly, is a preventable problem. The study also highlights the value of ‘Big Data’ from the MEDNAX Clinical Data Warehouse in defining emerging issues such as this one.”

Using multiple cross-sectional analyses, researchers affiliated with MEDNAX’s Clinical Research, Education and Quality efforts analyzed infants with NAS from 2004 to 2013 in 299 NICUs across the United States from a de-identified dataset. During the study period, the rate of NICU admissions for NAS increased nearly four-fold, from 7 to 27 per 1,000 admissions; the median length of stay increased from 13 to 19 days; and the total percentage of nationwide NICU days devoted to care of NAS infants increased from 0.6% to 4.0%, representing a 6.7-fold increase.

In addition to publishing this study, MEDNAX has been an active participant in awareness efforts related to the rising burden of NAS on the United States healthcare system. In March, Dr. Stefan Maxwell, Chair of the West Virginia Perinatal Partnership, testified before a House of Representatives Committee on the topic in conjunction with the introduction of the Protecting Our Infants Act, which directs the Department of Health and Human Services to make recommendations for diagnosis and treatment of NAS.

Dr. Spitzer added, “It is important to note that while the neonatologist is the clinician confronted with this problem, by the time the infant arrives in the NICU, his or her pathway is already in motion. Women who are contemplating pregnancy must be made aware of the risks of narcotics to their fetus, so that the problem can be avoided.”

The study was a collaborative effort between MEDNAX and Baylor Scott & White Health. Veeral N. Tolia, M.D., a MEDNAX physician and faculty at Baylor University Medical Center’s Division of Neonatology and Department of Pediatrics, is the principal author, and Dr. Spitzer is senior author. The study can be found online at http://www.nejm.org/doi/full/10.1056/NEJMsa1500439.

ABOUT MEDNAX

MEDNAX, Inc. is a national medical group comprised of the nation’s leading providers of neonatal, anesthesia, maternal-fetal and pediatric physician subspecialty services. Physicians and advanced practitioners practicing as part of MEDNAX are reshaping the delivery of care within their specialties and subspecialties, using evidence-based tools, continuous quality initiatives and clinical research to enhance patient outcomes and provide high-quality, cost-effective care. Pediatrix Medical Group, a division of MEDNAX, was founded in 1979 and includes neonatal physicians who provide services at more than 370 neonatal intensive care units, and collaborate with affiliated maternal-fetal medicine, pediatric cardiology, pediatric critical care and other physician subspecialists to provide a clinical care continuum. Pediatrix is also the nation’s largest provider of newborn hearing screens. American Anesthesiology, a division of MEDNAX, was established in 2007 and includes more than 2,400 anesthesiologists and advanced practitioners who provide anesthesia care to patients in connection with surgical and other procedures as well as pain management. MEDNAX, through its affiliated professional corporations, employs more than 2,675 physicians in 34 states and Puerto Rico. In addition to its national physician network, MEDNAX provides services to medical providers in over 40 states through two complementary businesses, consisting of a revenue cycle management company and a consulting services company. Additional information is available at www.mednax.com.

Certain statements and information in this press release may be deemed to contain forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995, Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended. Forward-looking statements may include, but are not limited to, statements relating to our objectives, plans and strategies, and all statements, other than statements of historical facts, that address activities, events or developments that we intend, expect, project, believe or anticipate will or may occur in the future. These statements are often characterized by terminology such as “believe”, “hope”, “may”, “anticipate”, “should”, “intend”, “plan”, “will”, “expect”, “estimate”, “project”, “positioned”, “strategy” and similar expressions, and are based on assumptions and assessments made by MEDNAX’s management in light of their experience and their perception of historical trends, current conditions, expected future developments and other factors they believe to be appropriate. Any forward-looking statements in this press release are made as of the date hereof, and MEDNAX undertakes no duty to update or revise any such statements, whether as a result of new information, future events or otherwise. Forward-looking statements are not guarantees of future performance and are subject to risks and uncertainties. Important factors that could cause actual results, developments, and business decisions to differ materially from forward-looking statements are described in MEDNAX’s most recent Annual Report on Form 10-K and its Quarterly Reports on Form 10-Q, including the sections entitled “Risk Factors”, as well MEDNAX’s current reports on Form 8-K, filed with the Securities and Exchange Commission.

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