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Between 2004 and 2013 the incidence of neonatal abstinence syndrome (NAS) in the United States increased by nearly 500%. The increase was greater in rural areas than in urban areas. In rural areas, the incidence increased from 1.2 cases per 1,000 births in 2003-2004 to 7.5 cases per 1,000 births in 2012-2013, approximately 520%. During the same period, in urban areas, the incidence increased from 1.4 cases per 1,000 births in 2003-2004, to 4.8 per 1,000 births in 2012-2013, approximately 240%. The proportion of infants diagnosed with NAS . . .

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