Maternal Substance Research Articles

The association between maternal and paternal substance use and child substance use, internalizing and externalizing problems: a systematic review and meta-analysis.

There is substantial evidence showing an association between parental substance use and child substance use and/or mental health problems. Most research focuses upon maternal substance use, with the influence of paternal substance use often being overlooked. We aimed to investigate the differential effects of maternal and paternal substance use upon children aged 0-18 years. We used systematic review methods to identify observational studies examining the association between either maternal or paternal substance use and child substance use and/or mental health problems. The odds ratio (OR) effect measure was used, for ease of computation. We used a random-effects model with the inverse variance method to meta-analyse the findings from eligible studies. We included 17 unique studies with a total of 47 374 child participants. Maternal and paternal substance use were both associated with increased odds of child any drug use [OR = 2.09; 95% confidence interval (CI) = 1.53, 2.86; n = 12 349 participants; three studies and OR = 2.86; 95% CI = 1.25, 6.54; n = 5692 participants; three studies, respectively], child alcohol problem use (OR = 2.16; 95% CI = 1.73, 2.71; n = 7339 participants; four studies and OR = 1.70; 95% CI = 1.36, 2.12; n = 14 219 participants; six studies), child externalizing problems (OR = 1.81; 95% CI = 1.01, 3.22; n = 1748 participants; three studies and OR = 1.60; 95% CI = 1.18, 2.17; n = 2508 participants; six studies) and child internalizing problems (OR = 1.60; 95% CI = 1.25, 2.06; n = 1748 participants; three studies and OR = 1.42; 95% CI = 1.12, 1.81; n = 2248 participants; five studies). Child any alcohol use was associated with maternal substance use only (OR = 2.26; 95% CI = 1.08, 4.70; n = 28 691 participants; five studies). Both maternal and paternal substance use are associated with child substance use and mental health problems.

Effects of maternal toxic substance consumption during breastfeeding on lactic acid bacteria abundance and nutritional content.

Breast milk is widely recognized as the primary source of nourishment for newborns, making it an unparalleled and indispensable provider of essential nutrients, microbiological components, immunological factors, and energy content. To investigate this further, a cohort comprising 254 breastfeeding women participated in interviews, and milk samples were aseptically collected for subsequent analysis involving bromatological, microbiological, and clinical analysis. The investigation focused on the identification of specific microorganisms in breast milk and their susceptibility to the exposure of toxic substances and controlled medications. Notably, this study places particular emphasis on the significant decline in lactic acid bacteria observed in breast milk when influenced by substances such as cocaine, cannabis, crystal, and morphine. These detrimental agents have been found to adversely affect the growth of microorganisms within breast milk. On the contrary, the outcomes of this study indicate that the utilization of toxic substances does not exert a noteworthy impact on the nutritional quality of breast milk.

Examining racial differences in substance use and HCV among birthing women in a midwestern prison

Given limited data in incarcerated pregnant people, our study aimed to examine the rates of substance use in pregnancy, medications for opioid use disorder, mood disorders, and HCV of Black and White incarcerated women. We conducted a retrospective chart review of women from Michigan’s state prison who had a live hospital birth from January 1st, 2010 through May 31st, 2019. Trinity Health provides all delivery care for incarcerated women in Michigan. Rates of maternal substance use and HCV were determined. Comparisons were completed using Fisher’s exact test. Two hundred and eight women delivered in the study period. Racial distribution was Black (n=77) and White (n=131). Rates of drug use in pregnancy were higher among White women (35.1% vs 16.9%, p < 0.01), as was opioid use (24.4% vs 9.1%, p< 0.05) and medications for opioid use disorder (MOUD) (14.5% vs 2.6%, p < 0.05). Of the 21 women who received MOUD, 17 received methadone and four received buprenorphine. All patients who received buprenorphine were White. White women also had higher rates of HCV (23.7% vs 2.6, p< 0.001). Sixty-four (30.8%) and eleven (5.3%) women used tobacco and alcohol respectively in pregnancy, with no statistical difference by race. Among those who gave birth while incarcerated in Michigan, White women had higher rates of drug and opioid use, MOUD, and HCV than Black women. Additionally, no Black women received buprenorphine. Further research investigating the impact of societal-level conditions including racism, poverty, and geographical sentencing patterns on pregnant people is needed. Targeted interventions must be anti-racist and address pre-incarceration factors as well as justice in care.

Evaluation of Perinatal and Developmental Outcomes in Neonates with Abstinence Syndrome Admitted to NICU

Drug abuse by pregnant women is one of the significant problems for mothers and their neonates. This study aimed to investigate the effects of maternal substance use disorder during pregnancy on neonatal developmental criteria. In a case-control study, clinical records of 90 neonates diagnosed with neonatal abstinence syndrome who were admitted to NICU in one of four hospitals affiliated with Shahid-Beheshti University of Medical Sciences in Tehran, Iran between 2017 and 2020 were compared to 90 neonates without neonatal abstinence syndrome (control group). Demographic information and data for neonatal developmental characteristics and complications were extracted from the clinical records of this convenience sample. Data for the type and method of maternal substance use during pregnancy were collected through a telephone call with mothers. Our data showed that the prevalence of drug addiction was 1.8% among pregnant women, and the most common drugs used by mothers were opium (n = 45%, 50%), amphetamine (n = 30%, 33%), and methadone (n = 14%, 16%). Neonates with abstinence syndrome had a higher prevalence of transient tachypnea of the newborn (TTN) (<i>P</i> = 0.004), and a prevalence of being admitted to NICU (<i>P</i> = 0.05) and for a longer duration (<i>P</i> < 0.001). Their mothers had a higher prevalence of having pre-eclampsia (<i>P</i> = 0.010). Using morphine vs. amphetamine showed no difference based on their effects on mothers and neonates. Substance use during pregnancy increased the prevalence of pregnancy complications (pre-eclampsia) and neonatal complications (TTN and prevalence and duration of hospitalization). Therefore, planning for the development of health policies to raise awareness among women and more broadly, all members of the community, is important to prevent the tendency to engage in this potentially high-risk behavior.

Implementation of universal screening for substance use in pregnancy in a public healthcare system

Reported rates of maternal substance use include 6% illicit drugs, 10% tobacco, and 10% alcohol from the 2019 National Survey on Drug Use and Health. We evaluate the implementation of a validated, universal screening tool to identify self-reported substance use disorder (SUD) in pregnancy at an inner-city public health system.

Prenatal smoking, drinking, or caffeine does not affect ADHD symptoms in offspring

A recent study has found that in contrast to some previously published studies, maternal prenatal substance use with legal substances is not associated with offspring attention‐deficit hyperactivity disorder (ADHD). For the study, researchers measured associations between prenatal smoking, alcohol, and caffeine consumption with childhood ADHD symptoms. They took into consideration shared familial factors.

Maternal opioid addiction: A potential cause of elevated 17-OH progesterone in neonatal screening

BackgroundCongenital adrenal hyperplasia (CAH) is a disease that is part of neonatal screening. There are many causes of false-positive results on neonatal screening, and maternal opioid consumption during pregnancy is suspected to increase 17-hydroxyprogesterone (17-OHP) levels at birth. The aim of this study was to determine the effect of maternal drug consumption on 17-OHP values on neonatal screening. Material and methodsWe studied 17-OHP levels of term newborns with reported maternal drug consumption born at the Maternity Hospital of Nancy between 2002 and 2018. These infants were matched with newborns of mothers without drug addiction. The 17-OHP levels, withdrawal syndromes, birth parameters, and maternal characteristics were compared between the two groups. ResultsThe study included 241 patients (121 in the drug-exposed group, 120 in the control group). The mean 17-OHP levels in newborns of mothers with substance addiction were 9.83 nmol/L compared to 4.90 nmol/L (p=0.0001) in the control group. Newborns exposed to drugs were smaller (p=0.0001), lighter (p=0.0001), had smaller head circumference (p=0.0001), and had lower Apgar scores (p=0.004 at 1 min and p=0.0001 at 5 min). The 17-OHP level did not differ in cases of withdrawal syndrome in drug-exposed newborn (p=0.911). ConclusionA significant increase in 17-OHP levels was observed in newborns exposed to drugs, with no influence of withdrawal syndrome on 17-OHP levels. Maternal substance addiction may be associated with moderately increased 17-OHP levels during neonatal screening.

Patterns and predictors of material hardship among poor families with children.

Experiences of material hardship vary across poor families, but little is understood about this variability. The present study aimed to distinguish subtypes of material hardship as well as which characteristics predict subtypes. Latent class analysis with data from a large, longitudinal study of families with youth children investigated subtypes of material hardship as well as predictors of subtypes. Multinomial logistic regression then predicted class membership used on known housing risk factors maternal IPV victimization, depression, and substance use. Analyses identified three distinct subtypes of material hardship: "Housing Insecure," "Food Insecure," and "Cost-Burdened but Managing." Maternal IPV victimization and depression reduced likelihood of membership in the "Managing" class, but no predictors distinguished families who become food versus housing insecure. Findings suggest widespread financial stress and complex tradeoffs for low-income families, who struggle to afford basic needs. Maternal safety and mental health prove crucial to families' coping abilities. Increased systemic supports targeting specific circumstances may promote stability and prevent more severe hardship.

Maternal use of substances while pregnant does not affect ADHD symptoms in offspring

A recent study has found that in contrast to some previously published studies, maternal prenatal substance use with legal substances is not associated with offspring attention‐deficit hyperactivity disorder (ADHD). For the study, researchers measured associations between prenatal smoking, alcohol, and caffeine consumption with childhood ADHD symptoms. They took into consideration shared familial factors.

Children, Adolescents, and Young Adults with Borderline Intellectual Functioning: Etiological, Neurophysiological, and Mri Findings in a Cohort of 651 Patients.

This retrospective chart review study explored the etiology, use, and yield of the etiological investigations of 651 children and adolescents diagnosed with borderline intellectual functioning (BIF). Neurological, neurodevelopmental, or neuropsychiatric comorbidities were frequent, and in 23%, the BIF diagnosis evolved into an intellectual disability (ID) by the time of discharge. A primary etiological cause was found in 37.6%, the most prevalent causes being pre- or perinatal conditions, genetic syndromes/chromosomal abnormalities, fetal exposure to maternal substance use, cerebral dysgenesis, and neurological diseases. In total, 79.1% of patients went through one or more investigations during their follow-up. The best etiologic yield leading to a diagnosis in this study population was with exome sequencing, a specific gene panel, microarrays, electroneuromyography, and brain magnetic resonance imaging (MRI). Etiological investigations were performed more frequently among those children receiving an ID diagnosis. Yet, there was no statistically significant difference in the proportion of abnormal findings between the BIF and ID groups. This may mean that the current strategy for determining the need for etiological investigations or current means to gain an etiology is still indecisive. Considering that BIF is defined to include individuals performing between normal cognitive functioning and mild ID, this implies that the prevalence would be anywhere between 7 and 14%. Thus, it could be argued whether in-depth etiological investigations may be justified in cases other than ID in this age group of children over five. With these children and adolescents, the clinicians have to discern between those with a normal variation and those having major difficulties in adaptive behavior affecting everyday life in order to specify and prescribe the rehabilitation or other measures needed. We advocate for a targeted etiological search after careful history-taking and neurological examination. National guidelines that take into account the severity of developmental delay are warranted.

EPID-22. MATERNAL USE OF TOBACCO, ALCOHOL, AND ILLICIT DRUGS DURING PREGNANCY AND ASSOCIATION WITH CHILDHOOD CANCER SUBTYPES

Abstract OBJECTIVE To investigate the association between maternal prenatal substance use/abuse and diagnosis of childhood cancer subtypes, including childhood brain tumors. To minimize recall bias, we employed a case-only study design in which all respondents had a child diagnosed with cancer. STUDY DESIGN: We deployed a cross-sectional, case-only survey of parents of children diagnosed with cancer regarding prenatal smoking, drinking, and illicit drug use behaviors (scored on 1-7 Likert scale), demographic, gestational, and perinatal factors. Multivariable logistic regression assessed associations of gestational smoking, alcohol, and illicit drug use with childhood cancer subtypes, adjusting for child sex, race/ethnicity, birthweight, and household income. RESULTS 3145 families completed the survey, including 232 with astrocytoma (grades I-IV, including DIPG) and 210 with an embryonal CNS tumor (medulloblastoma, AT/RT, PNET). A minority reported ever smoking tobacco products during pregnancy (Likert score ≥ 2; 14%), ever consuming illicit drugs during pregnancy (Likert score ≥ 2; 4%), or drinking more than a moderate amount of alcohol during pregnancy (Likert score ≥ 5; 2%). Prenatal smoking was associated with lower odds of rhabdomyosarcoma (OR=0.48, P=0.023) and moderately elevated odds of non-Hodgkin lymphoma (OR = 1.52, P=0.098) and AML (OR = 1.52, P = 0.083). Moderate to heavy alcohol consumption was unassociated with cancer subtypes. Prenatal illicit drug use was associated with increased odds of retinoblastoma (OR = 5.03, 95% CI = 1.73-14.7, P = 0.003) and CNS embryonal tumors (OR = 2.56, 95% CI = 1.32-4.99, P = 0.006), with similar effects across subgroups of medulloblastoma, AT/RT, and supratentorial PNETs. CONCLUSIONS Associations between self-reported use of alcohol, tobacco, and illicit drugs during pregnancy and risk of childhood cancer is often biased by differential misreporting among parents of affected children. Consistent with prior reports, we observe elevated odds of hematologic malignancies in association with gestational tobacco smoke exposure and novel association between maternal illicit drug use during pregnancy and elevated odds of retinoblastoma and CNS embryonal tumors.

Timeliness of Early Identification and Referral of Infants with Social and Environmental Risks.

The Early Intervention Parenting Partnerships (EIPP) program is a home visiting program that provides home visits, group services, assessments and screenings, and referrals delivered by a multidisciplinary team to expectant parents and families with infants who experience socioeconomic barriers, emotional and behavioral health challenges, or other stressors. The present study examines whether EIPP successfully meets its aims of screening families for social and environmental factors that may increase the risk of children’s developmental delays and connect them to the larger statewide early intervention (EI) system relative to families with similar background characteristics who do not receive EIPP. Coarsened exact matching was used to match EIPP participants who enrolled between 2013 and 2017 to a comparison group of families identified from birth certificates. Primary study outcomes including EI referrals, evaluations, and service receipt for children from 3 months to 3 years were measured using EI program data. Secondary outcomes included EI referral source, EI eligibility criteria (e.g., presence of biological, social, or environmental factors that may increase later risk for developmental delay), and information on service use. Impacts were assessed by fitting weighted regression models adjusted for preterm birth and maternal depression and substance use. EIPP participants were more likely than the comparison group to be referred to, evaluated for, and receive EI services. EIPP facilitated the identification of EI-eligible children who are at risk for developmental delays due to social or environmental factors, such as violence and substance use in the home, child protective services involvement, high levels of parenting stress, and parent chronic illness or disability. EIPP serves as an entry point into the EI system, helping families attain the comprehensive supports they may need to optimize their well-being and enhance children’s development.

Development and validation of a goal attainment scale for families affected by maternal substance use.

The Team for Infants Exposed to Substance use (TIES) Program is a longstanding home-based family support program that provides a multidisciplinary, community-facing model to address the complex needs of families with young children affected by maternal substance use. The model required a comprehensive assessment tool to guide creation of individualized family goals with steps to achievement and measurement of progress on those goals. This article describes the development of a goal attainment scale and the analysis conducted to validate the scale for the service population. TIES model developers and community partners developed the goal attainment scale to assess outcomes in key domains: maternal substance use, parenting, child and maternal health, income, and housing. Data were collected from 2012 to 2019 from 220 participants and analyzed in 2020. Exploratory factor analysis (EFA) and confirmatory factor analysis were conducted. Twenty-five of the original 30 items were retained in a six-factor structure. The total percentage of variance explained was 64.44% with six factors, and Cronbach's alpha was .90. For the split-half method, the reliability of scale was .90 for unbiased conditions. Therefore, the scale reached acceptable reliability and validity. The scale provides a comprehensive approach to measure family outcomes across multiple domains addressing key risk and protective factors. This family-centered scale serves both therapeutic and evaluation purposes, acting as an intervention guide and a goal attainment measurement tool.

Reflective functioning in mothers with addictions: Differential relationships involving family history of mental illness and substance use.

Parental reflective functioning (RF) is often cited as an important domain in which mothers with addictions struggle in their roles as parents, though the links between addiction and RF remain unclear. Exposure to attachment trauma associated with parental mental illness and substance use is commonly associated with both addiction and lower RF. We thus examined how family history of parental mental illness and substance use may relate to the RF of mothers with addictions. One hundred ninety-four mothers in outpatient substance use treatment completed the Parent Development Interview and provided information about whether their mothers and fathers experienced mental illness or problems with substance use. Univariate ANOVAs revealed an interaction between family history of maternal mental illness and maternal substance use. Among mothers with a history of maternal substance use, those with a history of maternal mental illness had higher RF than those who had no history of maternal mental illness. Among mothers who did not report a family history of maternal mental illness, mothers who had a family history of maternal substance use exhibited significantly lower RF than mothers with no family history of maternal substance use. Exposure to paternal mental illness or substance use was not associated with mothers’ RF. These findings highlight the importance of disentangling the contributions of attachment trauma to mothers’ RF and utilizing interventions that support mothers’ capacity to reflect about how their early experiences of being cared for by a mother with a mental illness or addiction may impact their current caregiving behaviors.

Prenatal exposure to a natural disaster and early development of psychiatric disorders during the preschool years: stress in pregnancy study.

Growing evidence shows an association between in utero exposure to natural disasters and child behavioral problems, but we still know little about the development of specific psychopathology in preschool-aged children. Preschool children (n = 163, mean age = 3.19, 85.5% racial and ethnic minorities) and their parents (n = 151) were evaluated annually at ages 2-5 to assess the emergence of psychopathology using the Preschool Age Psychopathological Assessment (PAPA), a parent-report structured diagnostic interview developed for preschool-age children. Sixty-six (40.5%) children were exposed to Sandy Storm (SS) in utero and 97 (59.5%) were not. Survival analysis evaluated patterns of onset and estimated cumulative risks of psychopathology among exposed and unexposed children, in total and by sex. Analyses were controlled for the severity of objective and subjective SS-related stress, concurrent family stress, and demographic and psychosocial confounders, such as maternal age,race, SES, maternal substance use, and normative prenatal stress. Exposure to SS in utero was associated with a substantial increase in depressive disorders (Hazard Ratio (HR) = 16.9, p = .030), anxiety disorders (HR = 5.1, p < .0001), and attention-deficit/disruptive behavioral disorders (HR = 3.4, p = .02). Diagnostic rates were elevated for generalized anxiety disorder (GAD; HR = 8.5, p = .004), attention-deficit/hyperactivity disorder (ADHD; HR = 5.5, p = .01), oppositional-defiant disorder (ODD; HR = 3.8, p = .05), and separation-anxiety disorder (SAD; HR = 3.5, p = .001). Males had distinctively elevated risks for attention-deficit/disruptive behavioral disorders (HR = 7.8, p = .02), including ADHD, CD, and ODD, whereas females had elevated risks for anxiety disorders (HR = 10.0, p < .0001), phobia (HR = 2.8, p = .02) and depressive disorders (HR = 30.0, p = .03), including SAD, GAD, and dysthymia. The findings demonstrate that in utero exposure to a major weather-related disaster (SS) was associated with increased risk for psychopathology in children and provided evidence of distinct psychopathological outcomes as a function of sex. More attention is needed to understand specific parent, child, and environmental factors which account for this increased risk, and to develop mitigation strategies.

Association of maternal perfluoroalkyl substance exposure with postpartum haemorrhage in Guangxi, China

Postpartum haemorrhage (PPH) is the leading cause of maternal death worldwide, and it may be caused by environmental endocrine disruptors. Prenatal exposure to perfluoroalkyl substances (PFASs) in women has been linked to pregnancy disorders and adverse birth outcomes, but no data are available on the relationship between PFAS exposure during pregnancy and postpartum haemorrhage. This study aimed to explore the associations of maternal PFAS exposure with the postpartum haemorrhage risk and total blood loss. A total of 1496 mother-infant pairs in the Guangxi Zhuang birth cohort were included between June 2015 and May 2018. The concentration of PFASs in serum was detected using ultrahigh liquid chromatography-tandem mass spectrometry. Multiple binomial regression and linear regression models were used to analyse individual PFAS exposures. The mixture of PFASs was analysed using Bayesian Kernel Machine Regression (BKMR). In single substance exposure models, exposure to perfluorohexanesulfonic acid (PFHxS) increased the risk of postpartum haemorrhage (OR: 3.42, 95 % CI: 1.45, 8.07), while exposure to perfluorododecanoic acid (PFDoA) was inversely associated with the risk of postpartum haemorrhage (OR: 0.42, 95 % CI: 0.22, 0.80). The concentrations of perfluoroundecanoic acid (PFUnA) (β: 0.06, 95 % CI: 12.32, 108.82) and perfluorononanoic acid (PFNA) (β: 0.05, 95 % CI: 0.40, 88.95) exposure were positively correlated with the amount of postpartum haemorrhage; this result occurred only in the absence of covariate adjustment. In BKMR models, the risk of postpartum haemorrhage increased with increasing exposure to a PFAS mixture. In conclusion, our study suggested that maternal serum PFAS exposure during pregnancy was associated with the risk of postpartum haemorrhage.

Medicaid expansion in Oregon and postpartum healthcare among people with and without prenatal substance use disorder

BackgroundPeople with a maternal substance use disorder (SUD) may experience a lack of access to necessary healthcare and more specifically, postpartum healthcare. It is not known whether increased insurance coverage introduced by Medicaid expansion has improved postpartum healthcare utilization among this population. MethodsOregon 2008–2016 birth certificates and Medicaid claims were used to examine whether continuous insurance enrollment and postpartum healthcare utilization increased post-Medicaid expansion in a population with and without SUD (n = 9,337). International Classification of Diseases codes were used to identify deliveries, SUD, and postpartum healthcare. Univariable and multivariable generalized linear regression with standard errors clustered by individual were used to estimate the association between Medicaid expansion and postpartum healthcare utilization, stratified by maternal SUD. ResultsAmong the 10.3% with SUD, expansion was not associated with increased continuous enrollment or postpartum healthcare utilization. Among those without SUD, post-expansion deliveries were associated with increased continuous enrollment (+105.0 days; 95% CI=96.9–113.2), total (+4.4; 95% CI=2.9–6.0), postpartum (+0.3; 95% CI=0.2–0.4), inpatient (+0.9; 95% CI=0.7–1.1), outpatient (+2.3; 95% CI=1.4–3.3), office (+0.9; 95% CI=0.2–1.6), and emergency department (+0.3; 95% CI=0.1–0.5) visits. Among deliveries to postpartum people with SUD, 27.2% had opioid use disorder (OUD); expansion was associated with increased OUD medication use (12.0% vs 18.3%) and number of fills (6.7 vs 16.6). ConclusionsMedicaid expansion in Oregon was only associated with increased Medicaid-financed healthcare utilization for postpartum people without SUD, with the exception of those with OUD, demonstrating the need for assessing various strategies to improve postpartum healthcare utilization.

Prenatal Reflective Functioning as a Predictor of Substance-Using Mothers' Treatment Outcome: Comparing Results From Two Different RF Measures.

Mothers with prenatal substance use disorder (SUD) often show broad deficits in their reflective functioning (RF), implying severe risk for the relationship with their baby. Two different types of prenatal maternal RF may be important for parenting: adult attachment-focused-RF (AAI-RF), regarding parent's own childhood experiences, and parenting-focused RF (PRF) regarding their own current process of becoming a parent. However, their inter-relations and potentially different roles for parenting intervention outcomes are not clear. This study examined the associations between mothers' prenatal AAI-RF and pre- and post-natal PRF, and their role in mother-infant interaction and substance use as treatment outcomes. The participants were 57 treatment-enrolled pregnant mothers with SUD and 50 low-risk comparison mothers. AAI-RF was measured with the Adult Attachment Interview. For a subsample of 30 mothers with SUD, PRF was measured with Pregnancy Interview (during pregnancy/pre-intervention), and with Parent Development Interview at 4 months (during intervention). Mother-infant interaction was measured with Emotional Availability Scales at 4 and 12 months (post-intervention), and maternal substance use by post-natal substance relapses. Prenatal AAI-RF and pre- and post-natal PRF were highly associated with each other. Only higher prenatal PRF predicted better mother-infant interaction quality at 4 months and less substance use during the child's first year. Interestingly, prenatal PRF and AAI-RF predicted opposite changes in mother-infant interaction: lower prenatal PRF, but higher AAI-RF predicting more positive change. AAI-RF was especially associated with a change in maternal intrusiveness and hostility, indicating that it represents a more general regulatory tendency. Further studies are needed in larger and lower-risk samples. Our results suggest, however, that AAI-RF and PRF are partially distinct and should be uniquely targeted in perinatal interventions.

CHARACTERISTICS AND FACTORS ASSOCIATED WITH HEARING LOSS (DEAFNESS) IN CHILDREN ATTENDING THE MEDICAL CITY HOSPITAL, BAGHDAD, IRAQ

Background: Hearing loss (HL) is one of the commonest and neglected childhood disabilities. According to the World Health Organization (WHO), most of childhood hearing impairment is preventable. Studies showed that 31% of hearing impairment cases are caused by prenatal and postnatal infections, 17% are birth-related causes, 4% are ototoxic medications and about 8% related to other causes such as maternal substance abuse. Objective: To review factors associated with HL in a sample of children attending the Medical City Hospital in the Pediatrics Outpatient Clinic and Auditory Clinic; including congenital, early, or late onset and to investigate risk factors associated with HL. Methods: A cross sectional study, included children &lt;15 years with hearing loss attending the Medical City Hospital in the Pediatrics Outpatient Clinic and Auditory Clinic during the period from the 1st of July 2021 till the 30th of October 2021. Results: One hundred and one children with HL; 65.3% of them were males, 71.3% were preschoolers, 60.4% of them had family history of deafness, Severe deafness was found among 45.5% of children. Management was by Cochlear implantation for 60.4% of them and hearing aid for the rest. Causes of deafness were unknown in 39.6% of children, congenital among in 37.6%, acquired in 15.8% and mixed causes in 6.9%. Conclusion: Hearing impairment is severe deafness in most of the children included in this study. Family history, congenital infections and otitis media were the major causes of hearing impairment. Finally, cochlear implant was the management of choice in the majority of these children. Keywords: Hearing loss, cochlear implant, otitis media Citation: Qasim MF, AbdulKareem MN, Issa MA. characteristics and factors associated with hearing loss (deafness) in children attending the Medical City Hospital, Baghdad, Iraq. Iraqi JMS. 2022; 20(1): 68-76. doi: 10.22578/IJMS.20.1.9

Neonatal abstinence syndrome and mother's own milk at discharge.

To describe factors impacting receipt of mother's own milk (MOM) at discharge among California infants diagnosed with neonatal abstinence syndrome (NAS). Cohort study of the California Perinatal Quality Care Collaborative's Maternal Substance Exposure Database for infants with NAS and gestational age ≥ 34 weeks from 2019 to 2020. 245 infants with NAS were identified. Variables with an increased likelihood of being discharged on MOM included maternal medication assisted treatment (p = 0.001), use of maternal addiction services (p < 0.001), receiving donor human milk (p = 0.001), being treated in the well baby unit (p < 0.001), rooming-in (p < 0.001), and kangaroo care (p < 0.001). Among infants with NAS for whom MOM was recommended (n = 84), rooming-in was the only factor associated with being discharged on MOM (p = 0.002); receiving formula was the only inversely associated factor (p < 0.001). Results suggest supporting the mother-infant dyad and using non-pharmacologic treatment methods, such as rooming-in, increase receipt of MOM at discharge.