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Updated: Jun 30, 2026

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
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Before Birth, Beyond Childhood: Understanding the Influence of Prenatal Substance Exposure on Psychiatric Diagnoses

Logan Caola, Evan Dastin-Van Rijn, Shelby Anderson

    Medrxiv : the Preprint Server for Health Sciences
    |June 29, 2026
    PubMed

    Insights

    Prenatal substance exposure (PSE) increases the risk for childhood psychiatric diagnoses. Higher numbers of exposures correlate with greater odds of anxiety, behavioral, substance use, and mood disorders.

    Area of Science:

    • Child Psychology
    • Developmental Psychiatry
    • Public Health

    Background:

    • Prenatal substance exposure (PSE) occurs during fetal development.
    • PSE can lead to long-term mental health issues in children.
    • The relationship between PSE and psychiatric diagnoses requires further investigation.

    Purpose of the Study:

    • To examine the association between prenatal substance exposure and childhood psychiatric diagnoses.
    • To determine if exposure thresholds, cumulative effects, or individual substances are linked to specific diagnoses.
    • To quantify the odds ratios for psychiatric diagnoses based on PSE levels.

    Main Methods:

    • Utilized electronic health records from the University of Minnesota Adoption Medicine Clinic.
    • Identified PSE through caregiver narratives, child protective services, and toxicology reports.
    • Employed logistic regression to analyze exposure thresholds, cumulative counts, and individual substances against psychiatric diagnoses.

    Main Results:

    • Psychiatric diagnoses significantly increased with the number of prenatal substance exposures.
    • Anxiety Disorders showed elevated odds with increasing PSE, from OR 1.47 (1 exposure) to OR 2.03 (≥4 exposures).
    • Cumulative exposure was linked to Anxiety, Behavioral/Emotional, Substance Use, and Mood Disorders; alcohol, tobacco, and marijuana were individually associated with diagnoses.

    Conclusions:

    • Increasing prenatal substance exposure is associated with higher odds of psychiatric diagnoses.
    • The specific patterns of association vary by substance and psychiatric outcome.
    • Findings highlight the need for research into exposure timing and combinations for early intervention.
    Abstract

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