Prenatal substance exposure diagnosed at birth and infant involvement with child protective services
Prenatal substance exposure diagnosed at birth and infant involvement with child protective services
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DOI：
10.1016/j.chiabu.2017.10.002
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发表时间：
2018-02-01
影响因子：
4.8
通讯作者：
Putnam-Hornstein, Emily
中科院分区：
文献类型：
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作者：
Prindle, John J.;Hammond, Ivy;Putnam-Hornstein, Emily
婴儿的虐待报告率和寄养率最高。产前物质暴露被认为有助于早期参与儿童保护服务（CPS），但有有限的数据来检查这种关系或物质类型的变化。我们使用来自加州的关联出生、出院和CPS记录，估计了出生时医学诊断的物质暴露和新生儿戒断障碍的人群患病率。然后，我们探讨了相应的CPS参与率在第一年的生活物质类型调整后的社会人口和健康因素。在2006年出生的551，232名活产婴儿中，1.45%（n = 7994）在出生时被诊断为产前物质暴露; 61.2%的诊断者在1岁前报告给CPS，近三分之一（29.9%）被寄养。医学诊断的产前物质暴露与婴儿被报告给CPS的可能性密切相关，但CPS参与的可能性和水平的显着变化被观察到的物质类型。尽管这些数据无疑低估了产前非法药物和酒精使用的流行率，但本研究提供了一个基于人群的婴儿期CPS参与的共同途径的特征。未来的研究需要解释诊断为产前物质暴露的婴儿的长期轨迹，包括CPS的作用。
Infants have the highest rates of maltreatment reporting and entries to foster care. Prenatal substance exposure is thought to contribute to early involvement with child protective services (CPS), yet there have been limited data with which to examine this relationship or variations by substance type. Using linked birth, hospital discharge, and CPS records from California, we estimated the population prevalence of medically diagnosed substance exposure and neonatal withdrawal disorders at birth. We then explored the corresponding rates of CPS involvement during the first year of life by substance type after adjusting for sociodemographic and health factors. Among 551,232 infants born alive in 2006, 1.45% (n = 7994) were diagnosed with prenatal substance exposure at birth; 61.2% of those diagnosed were reported to CPS before age 1 and nearly one third (29.9%) were placed in foster care. Medically diagnosed prenatal substance exposure was strongly associated with an infant's likelihood of being reported to CPS, yet significant variation in the likelihood and level of CPS involvement was observed by substance type. Although these data undoubtedly understate the prevalence of prenatal illicit drug and alcohol use, this study provides a population-based characterization of a common pathway to CPS involvement during infancy. Future research is needed to explicate the longer-term trajectories of infants diagnosed with prenatal substance exposure, including the role of CPS.