Why screen newborns for cocaine: service patterns and social outcomes at age one year

Byrd, Robert S.; Neistadt, Allyson M.; Howard, Cynthia R.; Brownstein-Evans, Carol; Weitzman, Michael

doi:10.1016/s0145-2134(99)00031-9

Cited by 15 publications

(24 citation statements)

References 13 publications

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“…Fourteen of the neonates that were placed outside the mother's care had existing siblings, with all but one of these neonates having at least one sibling already placed in foster or kinship care or adoption. This is consistent with previous research [51] and highlights the serious risk of child protection issues within this high-risk, marginalized subset of women affected by substance abuse/dependence during pregnancy.…”

Section: Discussionsupporting

confidence: 93%

Clinical Features and Correlates of Outcomes for High-Risk, Marginalized Mothers and Newborn Infants Engaged with a Specialist Perinatal and Family Drug Health Service

Taylor

Hutchinson

Rapee

et al. 2012

Obstetrics and Gynecology International

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Background. There is a paucity of research in Australia on the characteristics of women in treatment for illicit substance use in pregnancy and the health outcomes of their neonates. Aims. To determine the clinical features and outcomes of high-risk, marginalized women seeking treatment for illicit substance use in pregnancy and their neonates. Methods. 139 women with a history of substance abuse/dependence engaged with a perinatal drug health service in Sydney, Australia. Maternal (demographic, drug use, psychological, physical, obstetric, and antenatal care) and neonatal characteristics (delivery, early health outcomes) were examined. Results. Compared to national figures, pregnant women attending a specialist perinatal and family drug health service were more likely to report being Australian born, Aboriginal or Torres Strait Islander, younger, unemployed, and multiparous. Opiates were the primary drug of concern (81.3%). Pregnancy complications were common (61.9%). Neonates were more likely to be preterm, have low birth weight, and be admitted to special care nursery. NAS was the most prevalent birth complication (69.8%) and almost half required pharmacotherapy. Conclusion. Mother-infant dyads affected by substance use in pregnancy are at significant risk. There is a need to review clinical models of care and examine the longer-term impacts on infant development.

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Section: Discussionsupporting

confidence: 93%

Clinical Features and Correlates of Outcomes for High-Risk, Marginalized Mothers and Newborn Infants Engaged with a Specialist Perinatal and Family Drug Health Service

Taylor

Hutchinson

Rapee

et al. 2012

Obstetrics and Gynecology International

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“…Evidence of maternal substance use, especially of illegal drugs such as heroin and cocaine, often results in the removal of the infant from maternal custody within the first 18 months of life (Byrd, Neistadt, Howard, Brownstein-Evans, & Weitzman, 1999;Nair et al, 1997). Removal of infant custody due to maternal use of cocaine is one of the leading causes of infant placement, with rates of placement over 60% in some urban areas (Neuspiel, Zingman, Templeton, DiStabile, & Drucker, 1993).…”

Section: Introductionmentioning

confidence: 99%

“…Protective service record reviews also indicate a strong link between maternal use of substances and child maltreatment, with 43-79% of affected children having at least one parent with a substance use disorder (Besinger, Garland, Litrownik, & Landsverk, 1999;Famularo, Kinscherff, & Fenton, 1992;Murphy et al, 1991). Prospective studies of cocaineusing mothers indicate high rates (43.5%) of caregiving disruption (Byrd et al, 1999;Nair et al, 1997;Singer et al, 2004) and of child maltreatment (9.3-23%) by 2 years (Leventhal et al, 1997;Wasserman & Leventhal, 1993).…”

Section: Introductionmentioning

confidence: 99%

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

Minnes

Singer

Humphrey-Wall

et al. 2008

Child Abuse & Neglect

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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.

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“…Infants that test positive at birth are more likely to be placed in foster care [170]. They are also more likely to have siblings in foster care and their mothers are more likely to have previous involvement with CPS.…”

Section: Policy Optionsmentioning

confidence: 99%

“…Increased communication between the agencies that provide care to these at risk infants and families is critical [170]. Coordinated case management can decrease obstacles to services [172].…”

Section: Policy Optionsmentioning

confidence: 99%

Substance use during pregnancy: time for policy to catch up with research

2004

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The phenomenon of substance abuse during pregnancy has fostered much controversy, specifically regarding treatment vs. punishment. Should the pregnant mother who engages in substance abuse be viewed as a criminal or as someone suffering from an illness requiring appropriate treatment? As it happens, there is a noticeably wide range of responses to this matter in the various states of the United States, ranging from a strictly criminal perspective to one that does emphasize the importance of the mother's treatment. This diversity of dramatically different responses illustrates the failure to establish a uniform policy for the management of this phenomenon. Just as there is lack of consensus among those who favor punishment, the same lack of consensus characterizes those states espousing treatment. Several general policy recommendations are offered here addressing the critical issues. It is hoped that by focusing on these fundamental issues and ultimately detailing statistics, policymakers throughout the United States will consider the course of action that views both pregnant mother and fetus/child as humanely as possible. Overview and nature of the problem IntroductionThe purpose of this review is to summarize policy research findings in the area of maternal prenatal substance abuse to (1) inform and advance this field, (2) identify future research needs, (3) inform policy making and (4) identify implications for policy. As a review, this is a systematic analysis of existing data (findings) on maternal drug use during pregnancy for determining the best policy among the alternatives for dealing with drug using mothers and their children. We will address issues of efficacy (which policies work?), economics (how much does it cost?) and politics (who is it for or against?). For new policies we will also consider how they fit with existing policies or laws, the social impact, ethical issues and the feasibility of implementation and administration.

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Why screen newborns for cocaine: service patterns and social outcomes at age one year

Cited by 15 publications

References 13 publications

Clinical Features and Correlates of Outcomes for High-Risk, Marginalized Mothers and Newborn Infants Engaged with a Specialist Perinatal and Family Drug Health Service

Clinical Features and Correlates of Outcomes for High-Risk, Marginalized Mothers and Newborn Infants Engaged with a Specialist Perinatal and Family Drug Health Service

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

Substance use during pregnancy: time for policy to catch up with research

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