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CHICAGO — A surge in US infants born with symptoms of withdrawal from heroin or strong prescription painkillers is driven largely by rising drug use among women in rural areas, a new study found.

The problem in urban and rural areas was about the same in 2004 — about 1 in 1,000 births were affected. But by 2013, the rural rate had climbed to almost 8 in 1,000. In urban areas, it reached 5 per 1,000 births.

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The rates correspond with women’s use of opioid drugs during pregnancy. This includes use or misuse of oxycodone and other prescription opioid painkillers, and use of illegal narcotics.

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