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Prenatal Substance Exposure and Infant Discharge Placement: Results From the ACT NOW Study
Tre D Gissandaner1, Jordan A Gette2, Kristin J Perry3,4
1Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA.
Child Maltreatment
|October 7, 2024
Summary
Infants exposed to substances during pregnancy, especially poly-substance use, face a higher risk of out-of-home placement. Withdrawal severity also impacts discharge decisions for these vulnerable infants.
Area of Science:
- Pediatrics
- Neonatal Care
- Public Health
Background:
- Identifying infants at risk for out-of-home placement is crucial.
- Prenatal substance exposure and demographic factors influence placement decisions.
Purpose of the Study:
- To examine factors associated with out-of-home placement for infants with prenatal substance exposure.
- To identify specific substance exposure patterns and withdrawal severity linked to placement outcomes.
Main Methods:
- Utilized a validated medical record data extraction tool on data from the ACT NOW study (N=30 sites).
- Analyzed data from 1808 birthing parent-infant dyads with documented Neonatal Opioid Withdrawal Syndrome (NOWS) scoring or prenatal opioid exposure.
- Employed latent class analysis to identify substance use patterns and their association with discharge destinations.
Main Results:
- Infants with prenatal exposure to alcohol, cocaine, meth/amphetamine, and opioids had lower probabilities of discharge to parents.
- Latent class analysis revealed distinct substance use classes associated with varying discharge probabilities.
- Less than half of infants in the Poly-use and Meth/amphetamine classes were discharged to parents (47%-49%).
- Withdrawal symptom severity influenced placement decisions in Poly-use and Prescription Opioid classes.
Conclusions:
- Prenatal substance exposure, particularly poly-substance use and meth/amphetamine exposure, significantly reduces the likelihood of infant discharge to parental care.
- Infant withdrawal severity is a critical factor in placement decisions for specific substance exposure classes.
- Findings support the need for enhanced support, identification, and safe care plans for substance-exposed infants and their families.
Keywords:
child protective servicesinfantlatent class analysisneonatal abstinence syndromeparentspatient dischargeMore Related Videos
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