There is growing documentation that infants exposed to opioids and poly-substances prenatally have an increased risk of aberrant development. In Norway, there are several in-patient clinics that specialize in medically supervised detoxification for pregnant women with substance dependence in a therapeutic setting. Because there is virtually no documentation on the perinatal outcome of the infants born to mothers receiving such treatment, this study aims to investigate the perinatal outcome of children born to mothers with opioid and poly-substance dependence detoxified in a residential setting during pregnancy compared with infants born to women with substance dependence at a time when no such treatment was available. Pregnant women from two time cohorts were followed from pregnancy to birth. Birth weight, head circumference, gestational age, and neonatal abstinence syndrome (NAS) were measured in infants born to mothers detoxified in a residential setting during pregnancy and compared with infants born to mothers receiving no treatment. Both study groups had concurrent comparison groups. Infants born to mothers in residential detoxification treatment experience less prenatal drug exposure and show better perinatal outcomes on gestational age and head circumference, as well as no NAS, compared to the infants in the earlier cohort whose mothers did not receive residential treatment. No miscarriages, complications, or morbidities were associated with residential detoxification treatment. Detoxification in residential treatment can be a preferred treatment form for many pregnant women struggling with drug abuse problems and should possibly be applied to a larger extent to ensure the best possible perinatal outcome for these children.

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This prospective, longitudinal study with data collected at four time points investigated how maternal psychiatric symptoms, substance abuse and maternal intrusiveness in interaction were related to early child language skills. Three groups of mothers were recruited during pregnancy: One from residential treatment institutions for substance abuse (n = 18), one from psychiatric outpatient treatment (n = 22) and one from well-baby clinics (n = 30). Maternal substance abuse and anti-social and borderline personality traits were assessed during pregnancy, postpartum depression at 3 months, maternal intrusiveness in interaction at 12 months, and child language skills at 2 years. Results showed that the mothers in the substance abuse group had the lowest level of education, they were younger and they were more likely to be single mothers than the mothers in the two other groups. There was a significant difference in expressive language between children born to mothers with substance abuse problems and those born to comparison mothers, however not when controlling for maternal age, education and single parenthood. No group differences in receptive language skills were detected. Results further showed that maternal intrusiveness observed in mother-child interaction at 12 months was significantly related to child expressive language at 2 years, also when controlling for socio-demographic risk factors. This suggests that in addition to addressing substance abuse and psychiatric problems, there is a need for applying treatment models promoting sensitive caregiving, in order to enhance child expressive language skills.

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