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Risk Factors for Foster Care Placement in Patients with Bronchopulmonary Dysplasia
Tyler L King1, A Ioana Cristea2, James E Slaven3
1Division of Newborn Medicine, Washington University School of Medicine in St. Louis, St Louis, Missouri.
Insights
Bronchopulmonary dysplasia (BPD) is linked to child welfare involvement. Maternal tetrahydrocannabinol positivity, mental health issues, and home insecurity are key risk factors for Department of Child Services (DCS) involvement and foster care placement.
Area of Science:
- Neonatal Medicine
- Pediatric Health
- Social Work in Healthcare
Background:
- Bronchopulmonary dysplasia (BPD) significantly impacts neonates, leading to prolonged hospitalizations and high healthcare demands.
- The stress and medical complexity associated with BPD can strain families, sometimes resulting in Department of Child Services (DCS) involvement or foster care placement.
Purpose of the Study:
- To identify specific risk factors associated with DCS involvement and foster care placement in infants diagnosed with BPD.
- To inform the development of targeted support services for vulnerable families affected by BPD.
Main Methods:
- Retrospective study of 246 infants born before 32 weeks gestation between 2010-2016.
- Analysis of data from infants requiring oxygen at 28 days and discharged from a tertiary care center.
- Identification of correlations between demographic, social, and clinical factors and DCS involvement or foster care placement.
Main Results:
- Department of Child Services (DCS) involvement occurred in 49 patients, with 13 requiring foster care.
- Risk factors for DCS involvement included maternal tetrahydrocannabinol (THC) positivity, hospital policy violations, maternal mental health diagnoses, and home insecurity.
- Home insecurity and maternal amphetamine use were significantly associated with foster care placement.
Conclusions:
- Multiple substance-related and non-substance-related factors increase the risk of DCS involvement in BPD cases.
- Home insecurity and maternal amphetamine use are critical indicators for foster care placement.
- This research addresses a gap in understanding the specific risk factors for child welfare system involvement in infants with BPD, aiding in proactive family support.
Objective:
Bronchopulmonary dysplasia (BPD) is a major cause of morbidity in neonates and can be associated with long hospitalization and high health care utilization. This extremely stressful situation can be difficult for many families and caregivers. The high-risk situation combined with increased medical complexity can result in involvement of Department of Child Services (DCS) and even foster care placement. This study seeks to define risk factors for DCS involvement and foster care placement in children with BPD.
Study Design:
A retrospective study of children born at less than 32 weeks of gestation born between 2010 and 2016, on oxygen at 28 days of life and discharged home from a tertiary care center.
Results:
A total of 246 patients were identified. DCS was involved in 49 patients with 13 requiring foster care placement. The most common correlated risk factors that were identified for DCS involvement were maternal THC (tetrahydrocannabinol) positivity, hospital policy violations, maternal mental health diagnosis, and home insecurity. Home insecurity (p < 0.005) and amphetamine use (p < 0.005) were associated with foster care placement.
Conclusion:
There are numerous risk factors for both DCS and foster care placement. The identification of these risk factors is important to help establish services to help families and identify potential biases to avoid.
Key Points:
· There were both substance-related and non-substance-related risk factors for DCS involvement.. · Home insecurity and maternal amphetamine use were risk factors associated with foster care placement.. · This study fills the knowledge gap of risk factors for DCS and foster care placement in BPD..
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