Prenatal Substance Exposure and Positive Developmental Delay Screening Among Patients in Foster Care

Area of Science:

• Pediatrics
• Developmental Psychology
• Public Health

Background:

• Prenatal substance exposure (PSE) is linked to adverse birth and neurodevelopmental outcomes.
• Children in foster care exhibit higher rates of PSE and developmental delays than the general population.

Purpose of the Study:

• To investigate developmental delay screening differences in foster care children with and without PSE.
• To identify specific risk factors, including prematurity, interacting with PSE.

Main Methods:

• Retrospective analysis of medical records for 975 foster care children (2018-2021).
• Cox proportional hazards regression used for developmental delay screening analysis.
• Controlled for sex, race, ethnicity, prematurity, and caregiver type; examined PSE interactions.

Main Results:

• 60.4% of children had PSE; 62.6% screened positive for developmental delay.
• PSE without prematurity increased delay screening hazard by 1.14 times.
• PSE with prematurity increased delay screening hazard by 2.01 times.

Conclusions:

• Foster care children with PSE are at increased risk for developmental delays.
• The combination of PSE and prematurity significantly elevates this risk.
• Consideration of PSE and prematurity interaction is crucial for effective developmental delay screening.