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Well-Child Care Adherence After Intrauterine Opioid Exposure

Neera K Goyal1, Jessica F Rohde2,3, Vanessa Short4

  • 1Departments of Pediatrics and neera.goyal@nemours.org.

Pediatrics
|January 4, 2020
PubMed

Insights

Children with intrauterine opioid exposure (IOE) show lower adherence to well-child care (WCC) visits in the first two years of life. This highlights a need for targeted support to ensure comprehensive care for these children.

Area of Science:

  • Pediatric primary care
  • Public health
  • Neonatal abstinence syndrome research

Background:

  • Well-child care (WCC) is crucial for addressing medical, developmental, and psychosocial needs of children.
  • Children with intrauterine opioid exposure (IOE) require specialized attention within WCC settings.

Purpose of the Study:

  • To evaluate adherence to WCC schedules for children with IOE.
  • To identify potential gaps in care for this vulnerable population.

Main Methods:

  • Retrospective cohort study using PEDSnet data (2011-2016).
  • IOE ascertained via physician diagnosis codes.
  • WCC adherence defined by visit completion in the first two years; multivariable regression used to analyze IOE impact.

Main Results:

  • Children with IOE (2.1%) had significantly lower WCC adherence in both the first and second years of life.
  • Increased likelihood of WCC gaps (≥2 missed consecutive visits) observed in children with IOE.
  • No significant differences in immunizations or lead screening adherence were found.

Conclusions:

  • Children with IOE demonstrate reduced adherence to recommended WCC visits.
  • Despite timely immunizations and lead screening, gaps in WCC persist for this population.
  • Further research is needed to optimize WCC for supporting the complex needs of children with IOE.
Abstract

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