Psychosocial and behavioral factors related to the post-partum placements of infants born to cocaine-using women

Abstract

Results of this study indicate that poor, urban women who use cocaine prenatally display several measurable differences on psychosocial and behavioral risk factors based on child placement status. Among these risk factors heavier cocaine use, lack of prenatal care, more severe psychological symptoms and early childhood experiences of emotional neglect increase the likelihood of loss of infant custody. Routine, objective assessments of psychosocial and behavioral characteristics of women who use cocaine during pregnancy can aid Child Protective Service workers and clinicians by providing baseline data from which to tailor interventions and set improvement criteria for mother-child reunification.

The association of prenatal cocaine use and childhood trauma with psychological symptoms over 6 years

“…This pattern of findings indicates that the associations of early childhood trauma with psychological symptoms may have varying degrees of relevance during different biologic and care giving stress states such as caring for an infant or toddler. Another study of this sample found greater psychological distress and early emotional neglect to be associated with increased likelihood of loss of infant custody among cocaine using women (Minnes et al 2008). In contrast, this study did not reveal an association of loss of infant custody with increased psychological distress at any time point.…”

“…For example, rates of clinically elevated psychoticism in the first 2 years post partum were (30-54%), paranoid ideation (30-53%), depression (18-36%), hostility (24-31%) and anxiety (15-27%). Elevation of these symptom domains have the potential for serious consequences for mothers including suicide (Holmstrand et al 2006), loss of infant custody (Minnes et al 2008) and increased rates of domestic violence (Nixon et al 2004;Stuart et al 2006). High rates of maternal psychopathology pose threats to infant well-being as well.…”

“…Negative effects of psychological symptoms on parenting include less sensitive maternal care giving behavior, experience of parenting stress and poor infant attachment (Eiden et al 2006;Espinosa et al 2001;Howard et al 1195;Minnes et al 2005;Sheinkopf et al 2006) and less optimal infant cognitive (Singer et al 1997) and language outcomes (Marques et al 2007). Despite the known negative effects of psychological distress on parenting among cocaine using women, very little is known about the natural history of mental health symptoms among cocaine using mothers (Jantzen et al 1998;Minnes et al 2000Minnes et al , 2008.…”

Effects of Prenatal Cocaine Exposure on Human Pregnancy and Postpartum

“…Cocaine use during pregnancy is considered a significant risk factor for infant neglect and abuse. Evidence of cocaine use in pregnancy often results in the removal of the in infant from maternal custody within the first 18 months of life [11]. Prospective studies have also indicated a strong link between cocaine-using mothers and child maltreatment, with high rates of care-giving disruption (43%) and child maltreatment by 2 years (9% to 23%) [11].…”

“…Evidence of cocaine use in pregnancy often results in the removal of the in infant from maternal custody within the first 18 months of life [11]. Prospective studies have also indicated a strong link between cocaine-using mothers and child maltreatment, with high rates of care-giving disruption (43%) and child maltreatment by 2 years (9% to 23%) [11]. Finally, a stable and secure home environment helps reduce the stressors associated with cocaine addiction, so any intervention in this regard may be extremely helpful.…”