Risk factors for disruption in primary caregiving among infants of substance abusing women

Nair, Prasanna; Black, Maureen M.; Schuler, Maureen E.; Keane, Virginia; Snow, Laurel; Rigney, Betty Ann; Magder, Laurence S.

doi:10.1016/s0145-2134(97)00064-1

Cited by 102 publications

(68 citation statements)

References 50 publications

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“…Pregnancy should bring the woman into contact with the health care system and may provide a 'window of opportunity' to engage the vulnerable and 'high risk' woman into essential health care (Nair et al, 1997). Many women with problematic drug use first come to the attention of treatment services when they seek care during pregnancy (Corse and Smith, 1998).…”

Section: Service Provision For Pregnant Womenmentioning

confidence: 99%

Different needs: Women's drug use and treatment in the UK

Simpson

McNulty

2008

International Journal of Drug Policy

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Section: Service Provision For Pregnant Womenmentioning

confidence: 99%

Different needs: Women's drug use and treatment in the UK

Simpson

McNulty

2008

International Journal of Drug Policy

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“…These findings are striking because not only did we use maternal affirmation plus positive toxicology screens to confirm PDE status, but we recruited a community comparison group that represented families who resided in the same low-income communities as the PDE children and had experienced many of the same environmental challenges associated with poverty, but had not experienced PDE or the early caregiver disruptions that frequently occur among drug using families. 35 Our analyses suggested that the perinatal, maternal, and family covariates, selected on the basis of developmentalecological theory, explained more variance in early child functioning than a history of PDE.…”

Section: Discussionmentioning

confidence: 76%

Children's Cognitive-Behavioral Functioning at Age 6 and 7: Prenatal Drug Exposure and Caregiving Environment

Nair

Black

Ackerman

et al. 2008

Ambulatory Pediatrics

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Objectives-To examine how prenatal drug exposure (PDE) and the caregiving environment relate to cognitive, academic, and behavioral performance at ages 6 and 7.Methods-A longitudinal follow-up was conducted of 111 children with PDE and a community cohort (CC) of 62 non-drug-exposed children. Children completed standardized tests of cognition (Stanford-Binet IV, SB-IV) and academic performance (Wide Range Achievement Test-3, WRAT-3). Caregivers completed ratings of child behavior problems (Child Behavior Checklist, CBCL).Analysis-Multivariate analyses were conducted adjusting for gender, prenatal tobacco exposure, number of caregiver placement changes, and three caregiver variables assessed at age 7 including depressive symptoms, employment status, and public assistance status.Results-After adjusting for perinatal and environmental variables, there were no significant exposure group differences in cognition, academic performance, or behavior problems. In comparison with males, females had higher scores on overall IQ and 4 of 8 SB-IV subtests, fewer caregiver-reported attention and aggression problems, and higher reading achievement scores. There were no significant gender by group interactions.Conclusion-When analyses were adjusted for perinatal and environmental variables, most associations between PDE and cognitive-behavioral functioning were attenuated. Regardless of drug exposure history, males performed more poorly than females on multiple cognitive-behavioral indices. Both exposed and non-exposed children were from low-income families and obtained scores substantially below normative expectations, demonstrating the insidious effects of poverty on children's development. Keywordsprenatal drug exposure; school age children; gender; low-income Correspondence: Prasanna Nair, 737 West Lombard Street, Room 116, Baltimore Maryland, 21201, 410-706-5289 (phone), 410-706-0653 (fax), (pnair@peds.umaryland.edu). None of the authors has a conflict of interest.Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Drug abuse among women of child-bearing age is a serious public health problem. Most of the research on the effects of prenatal drug exposure (PDE) has been conducted among young children; findings on performance during the school-age years have been mixed. Some investigators have found no associations between PDE and cognitive performance, 1,2 play behavior, 3 academic achievement, 2,4 attention, or teacher-rated classroom behavior. 2 In contrast, others have found associations between PDE and behavior problems, 1,5 symptoms of oppositional defiant disorder and ADHD, 6...

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“…Substance-using street youth may be more likely to abuse their children and lose parenting rights. 15,16 Children born into street living suffer tremendous adversity, including poor physical health, mental and behavioral problems, developmental delays, as well as social stigma and the potential for family separation. 17 Official registration of birthwhich is critical for access to government-supported services, including medical care and school enrollment-may be unavailable.…”

Section: Introductionmentioning

confidence: 99%

Multi-City Assessment of Lifetime Pregnancy Involvement among Street Youth, Ukraine

et al. 2011

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Although street youth are at increased risk of lifetime pregnancy involvement (LPI), or ever becoming or getting someone pregnant, no reports to date describe the epidemiology of LPI among systematically sampled street youth from multiple cities outside of North America. The purpose of our assessment was to describe the prevalence of and risk factors associated with LPI among street youth from three Ukrainian cities. We used modified time-location sampling to conduct a cross-sectional assessment in Odesa, Kyiv, and Donetsk that included citywide mapping of 91 public venue locations frequented by street youth, random selection of 74 sites, and interviewing all eligible and consenting street youth aged 15-24 years found at sampled sites (n=929). Characteristics of youth and prevalence of LPI overall and by demographic, social, sexual, and substance use risk factors, were estimated separately for males and females. Adjusted odds ratios (AORs) were calculated with multivariable logistic regression and effect modification by gender was examined. Most (96.6%) eligible youth consented to participate. LPI was reported for 41.7% of females (93/223) and 23.5% of males (166/706). For females, LPI was significantly elevated and highest (970%) among those initiating sexual activity at ≤12 years and for those reporting lifetime anal sex and exchanging sex for goods. For males, LPI was significantly elevated and highest (940%) among those who reported lifetime anal sex and history of a sexually transmitted infection. Overall, risk factors associated with LPI were similar for females and males. Among the total sample (females and males combined), significant independent risk factors with AORs ≥2.5 included female gender, being aged 20-24 years, having five to six total adverse childhood experiences, initiating sex at age ≤12 or 13-14 years, lifetime anal sex, most recent sex act unprotected, and lifetime exchange of sex for goods. Among street youth with LPI (n=259), the most recent LPI event was reported to be unintended by 63.3% and to have ended in abortion by 43.2%. In conclusion, our assessment documented high rates of LPI among Ukrainian street youth who, given the potential for negative outcomes and the challenges of raising a child on the streets, are in need of community-based pregnancy prevention programs and services. Promising preventive strategies are discussed, which are likely applicable to other urban populations of street-based youth as well.

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Risk factors for disruption in primary caregiving among infants of substance abusing women

Cited by 102 publications

References 50 publications

Different needs: Women's drug use and treatment in the UK

Different needs: Women's drug use and treatment in the UK

Children's Cognitive-Behavioral Functioning at Age 6 and 7: Prenatal Drug Exposure and Caregiving Environment

Multi-City Assessment of Lifetime Pregnancy Involvement among Street Youth, Ukraine

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