Educational Disabilities Among Children Born With Neonatal Abstinence Syndrome.
Educational Disabilities Among Children Born With Neonatal Abstinence Syndrome.
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DOI：
10.1542/peds.2018-0562
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发表时间：
2018-09
期刊：
影响因子：
8
通讯作者：
Jones TF
中科院分区：
文献类型：
--
作者：
Fill MA;Miller AM;Wilkinson RH;Warren MD;Dunn JR;Schaffner W;Jones TF
新生儿戒断综合征（NAS）是一种产后药物戒断综合征，可能在宫内阿片类药物暴露后发生。患有 NAS 的婴儿会出现不良神经行为后果；然而，教育成果尚未得到彻底审查。我们分析了田纳西州的数据，以了解出生时患有 NAS 的婴儿对特殊教育服务的需求。通过使用田纳西州医疗补助和出生证明数据，将 2008 年至 2011 年间在田纳西州出生的有 NAS 病史的婴儿与同期出生的无 NAS 病史的婴儿进行匹配 (1:3)。根据性别、种族和/或民族、年龄、出生居住地区和医疗补助登记状况对各组进行匹配。数据与田纳西州教育部幼儿期（3-8 岁）特殊教育数据相关联。使用条件多变量逻辑回归来评估 NAS 与选定的特殊教育结果之间的关联。共有 1815 名有 NAS 病史的儿童和 5441 名无 NAS 病史的儿童接受了评估。患有 NAS 的儿童更有可能被转介进行残疾评估（1815 名儿童中的 351 名 [19.3%] 对比 5441 名儿童中的 745 名 [13.7%]；P < .0001），以满足残疾标准（1815 名儿童中的 284 名 [15.6%] 对比 5441 名儿童中的 634 名 [11.7%]；P < .0001），并需要课堂教学治疗或服务（1815 名中的 278 名 [15.3%] vs 5441 名中的 620 名 [11.4%]；P < .0001）。这些发现在多变量分析中得到了证实，多个模型控制了孕产妇烟草使用、孕产妇教育状况、出生体重、胎龄和/或新生儿重症监护室入院情况。这项将健康和教育数据联系起来的新颖分析结果显示，有 NAS 病史的儿童随后出现教育障碍的可能性明显更大。
Neonatal abstinence syndrome (NAS) is a postnatal drug withdrawal syndrome that can occur after intrauterine opioid exposure. Adverse neurobehavioral outcomes have been documented in infants with NAS; however, educational outcomes have not been thoroughly examined. We analyzed Tennessee data to understand the need for special educational services among infants who are born with NAS. By using Tennessee Medicaid and birth certificate data, infants who were born in Tennessee between 2008 and 2011 with a history of NAS were matched (1:3) to infants who were born during the same period without a history of NAS. Groups were matched on the basis of sex, race and/or ethnicity, age, birth region of residence, and Medicaid enrollment status. Data were linked to Tennessee Department of Education special education data during early childhood (3–8 years of age). Conditional multivariable logistic regression was used to assess associations between NAS and selected special education outcomes. A total of 1815 children with a history of NAS and 5441 children without NAS were assessed. Children with NAS were significantly more likely to be referred for a disability evaluation (351 of 1815 [19.3%] vs 745 of 5441 [13.7%]; P < .0001), to meet criteria for a disability (284 of 1815 [15.6%] vs 634 of 5441 [11.7%]; P < .0001), and to require classroom therapies or services (278 of 1815 [15.3%] vs 620 of 5441 [11.4%]; P < .0001). These findings were sustained in a multivariable analysis, with multiple models controlling for maternal tobacco use, maternal education status, birth weight, gestational age, and/or NICU admission. Results of this novel analysis linking health and education data revealed that children with a history of NAS were significantly more likely to have a subsequent educational disability.
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影响因子：
4
作者：
Campbell, Frances A.;Pungello, Elizabeth P.;Burchinal, Margaret;Kainz, Kirsten;Pan, Yi;Wasik, Barbara H.;Barbarin, Oscar A.;Sparling, Joseph J.;Ramey, Craig T.
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