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[Medical-social outcome of 59 infants born to addicted mothers]
C Lejeune1, J C Ropert, S Montamat
1Service de Néonatologie, Hôpital Louis Mourier, Colombes.
Insights
Infants born to drug-addicted mothers face significant challenges, including high rates of withdrawal and developmental issues. Improved perinatal care is crucial for better outcomes in these vulnerable children.
Area of Science:
- Neonatal care
- Perinatal addiction
- Pediatric follow-up
Context:
- Follow-up of infants born to drug-addicted mothers is challenging due to social factors.
- Study analyzed perinatal and follow-up data of 59 infants from two neonatal units (1988-1993).
Purpose:
- To determine the precise outcome for infants born to drug-addicted mothers.
- To evaluate the effectiveness of current perinatal strategies.
Summary:
- High rates of opiate addiction, poly-intoxication, and HIV+ mothers were observed.
- Significant percentages of infants experienced prematurity, intrauterine growth retardation, and neonatal withdrawal symptoms.
- Long-term follow-up revealed mortality, varied living situations, and some severe sequelae related to prematurity, not direct drug effects.
Impact:
- Findings suggest a need for enhanced medico-psycho-social care for these pregnancies, mothers, and infants.
- Improved perinatal strategies, including methadone maintenance, can prevent problems like prematurity and enhance mother-infant attachment.
Background:
Follow up of children born to drug-addicted mothers is difficult because of social context. The aim of this study was to determine the precise outcome in a cohort of infants from two neonatal units. POPULATION AND METHODS; Analysis of perinatal and follow up data of 59 infants born to drug-addicted mothers, admitted from 1988 to 1993 in the neonatal units of Colombes and Neuilly.
Results:
Perinatal data: very poor social context; 100% addiction by opiates and very frequent polyintoxication; 21% HIV + mothers; 54% came later or not at all to prenatal care; 34% prematurity and 46% intrauterine growth retardation; 80% neonatal withdrawal symptoms. Precise follow up data is known for 95% of the infants at the age of 1 to 7 years: 5% died during the first year of life; 51% are living with their family (with or without their mother); 36% are in institutions or foster homes, and 8% are fully adopted; among 41 newborns discharged from neonatal unit to their mother, 34% have been secondarily placed by Child Protection Services. The only severe sequelae were not related to drug direct effect: 5 neurologic or respiratory chronic impairment related to prematurity, and 3 asymptomatic HIV + children; a few moderate behavioral problems appear to be related to social familial context. Among the 51 mothers, 6 died (5 by overdose) 19 are severely addicted, 10 have stopped addiction but 2 are HIV +, and 16 are lost to follow up.
Conclusions:
Analysis of this cohort and of the literature suggest a need for changing our perinatal strategies to ameliorate medico-psycho-social care of these pregnancies, mothers and infants, with or without methadone maintenance programs; these strategies have been proved to prevent perinatal problems (specially prematurity), and to improve mother-infant attachment.