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Updated: Aug 11, 2026

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Prevalence and Predictors of Early Intervention Referral Among Substance-Exposed Newborns

Stephanie L Bourque1, Blair W Weikel1, Sunah S Hwang1

  • 1Department of Pediatrics, Section of Neonatology, University of Colorado School of Medicine, Aurora, Colorado.

Hospital Pediatrics
|September 26, 2023
PubMed

Insights

Early intervention (EI) referral is inequitable for substance-exposed newborns (SENs). Factors like substance type and maternal insurance impact access, highlighting the need for systemic improvements.

Area of Science:

  • Neonatal care
  • Developmental pediatrics
  • Public health

Background:

  • Substance-exposed newborns (SENs) face developmental risks.
  • Equitable access to early intervention (EI) services is critical for mitigating these risks.
  • Current EI access for SENs is known to be inequitable.

Purpose of the Study:

  • To determine the prevalence of EI referral among SENs in a collaborative.
  • To identify predictors associated with EI referral for SENs.
  • To evaluate disparities in EI referral based on substance exposure and insurance status.

Main Methods:

  • Retrospective analysis of maternal-infant dyads with substance exposure documented in electronic medical records.
  • Statistical comparison of maternal/infant characteristics based on EI referral status using chi-squared, Fisher's exact, and ANOVA tests.
  • Multivariable Poisson regression models to assess independent associations between characteristics and EI referral.

Main Results:

  • Only 41% (504/1222) of identified SENs received EI referral.
  • Infants exposed to non-MOUD or polysubstances had lower referral rates compared to MOUD-exposed infants.
  • Infants with private or self-pay/no insurance had significantly lower referral rates than those with public insurance.

Conclusions:

  • Less than half of SENs received necessary EI services, indicating a significant gap in care.
  • Referral rates varied substantially based on the type of substance exposure and maternal insurance status.
  • Systemic changes are essential to ensure equitable EI service access for all SENs.
Abstract

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