State Initiatives to Improve Care for Infants With Prenatal Substance Exposure.

Perinatal substance use is rising in the United States, contributing to increasing numbers of infants with prenatal substance exposure and maternal mortality due to substance use disorder (SUD). Nearly every state in the United States has a Perinatal Quality Collaborative (PQC), and many focus on standardizing care, promoting evidence-based practices, and improving outcomes for pregnant people and infants affected by substance use. In this review, we summarize the strategies adopted by some PQCs including pregnancy and postpartum care bundles, universal SUD screening, mental health interventions, overdose prevention efforts, and management of neonatal opioid withdrawal syndrome. We describe positive outcomes of these initiatives, including decreased pharmacologic therapy and improved discharge practices. We also highlight some areas that require attention such as measuring short-term and long-term outcomes of these practices.