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How great is the risk of abuse in infants born to drug-using mothers?
K Street1, J Harrington, W Chiang
1Centre for Child and Adolescent Health, Hampton House, Cotham Hill, Bristol, UK. Karen_street_khan@yahoo.co.uk
Insights
Maternal drug use in the UK does not automatically mean poor parenting. While initial concerns may arise, most children of drug-using mothers do not face long-term child protection issues.
Area of Science:
- Public Health
- Child Development
- Maternal Health
Background:
- Maternal drug use is linked to child abuse in North America.
- UK data on this association is lacking.
- Drug cultures vary, making US data generalization difficult.
Purpose of the Study:
- To investigate child protection and surveillance markers for UK infants born to self-proclaimed drug-using mothers.
- To compare these markers with infants of non-drug users.
Main Methods:
- Prospective cohort study of pregnant drug users and matched non-drug users.
- Involved antenatal clinic referrals and hospital-based data.
- Child protection registers and health surveillance records were reviewed at 18 months.
Main Results:
- No significant difference in child protection proceedings between groups initially.
- Higher overall risk for children of drug users, but largely due to temporary care or short-lived concerns.
- Child health surveillance uptake was lower in both groups.
Conclusions:
- Maternal drug use does not inherently result in poor parenting standards.
- Further UK-specific research is required for accurate child protection risk assessment.
Unlabelled:
This prospective, cohort study reports early child protection and surveillance process markers for children born to self-proclaimed drug-using mothers.
Background:
A strong association is reported between maternal drug use and child abuse in North American studies. There are no systematic data describing this association for the UK population. Given the heterogeneous nature of drug cultures and associated behaviour it is difficult to generalize from US data to the UK population.
Methods:
The study group consisted of all women referred to a hospital-based antenatal clinic for pregnant drug users. Infants of non-drug users were matched for social class and gestational age. At 18 months the Bristol and surrounding area child protection registers and child health surveillance records were searched. Infants were coded as to whether they were the subject of an enquiry, case conference, registration, registration with subsequent deregistration, or taken into care.
Results:
There were 68 infants of drug users and 127 infants of non-drug users. Most (81%) of drug users were heroin and/or methadone users; half were using/had used intravenously. Child health surveillance uptake for both groups is lower than that reported for the Avon population as a whole during the study period, consistent with the relatively deprived populations represented. There is no statistically significant difference between the drug users and non-drug users. The overall risk of child protection proceedings was higher in children of drug users than in children of non-drug users. However, closer inspection of the data shows most of the excess risk is explained by the small group taken into care and the much larger group for whom the concerns were relatively shortlived as shown by their subsequent deregistration during the study period.
Conclusions:
Maternal drug use does not necessarily lead to unacceptable standards of parenting. More UK-based research is needed to inform the risk assessment process for child protection.
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