Neonatal outcomes of pregnant women attending integrated and standard substance use treatment programs in Ontario, Canada.

BACKGROUND: Substance use in pregnancy raises concern given its potential teratogenic effects. Given the unique needs of parenting people and the potential impact for developing children, specialized substance use treatment programs are increasingly being implemented for this population. Substance use treatment is associated with more positive neonatal outcomes compared with no treatment, however treatment models vary limiting our understanding of key treatment components/modelsFew studies have explored the influence of treatment model type (i.e., integrated treatments designed for pregnant clients compared with standard treatment models) and no studies have examined the influence of treatment model on neonatal outcomes using Canadian data. METHOD: We conducted a population-based cohort study of clients who were pregnant when initiating integrated (n = 564) and standard (n = 320) substance use treatment programs in Ontario, Canada. RESULTS: Neonatal outcomes did not significantly differ by treatment type (integrated or standard), with rates of adverse neonatal outcomes higher than published rates for the general population, despite receipt of adequate levels of prenatal care. While this suggests no significant impact of treatment, it is notable that as a group, clients engaged in integrated treatment presented with more risk factors for adverse neonatal outcomes than those in standard treatment. While we controlled for these risks in our analyses, this may have obscured their influence in relation to treatment type. CONCLUSION: Findings underscore the need for more nuanced research that considers the influence of client factors in interaction with treatment type. Pregnant clients engaged in any form of substance use treatment are at higher risk of having children who experience adverse neonatal outcomes. This underscores the urgent need for further investment in services and research to support maternal and neonatal health before and during pregnancy, as well as long-term service models that support women and children beyond the perinatal and early childhood periods.

Negative Emotionality and Internalizing Behaviors in Preschool Children: Moderating Role of Inhibitory Control.

Negative emotionality in childhood is typically positively associated with internalizing behaviors, whereas inhibitory control is negatively associated with internalizing behaviors. Recent work, however, has also found that inhibitory control paradoxically increases risk for internalizing behaviors in the context of some reactive temperamental styles. The purpose of the present study was to examine whether inhibitory control moderated the association between negative emotionality and prospective internalizing behaviors in typically developing preschoolers (N = 104, 51 girls, Mage = 3.46 years, SDage = 0.19). We found that negative emotionality at T1 was only positively associated with internalizing behaviors at T2 in preschoolers with relatively higher inhibitory control. Our results suggest that relatively high levels of inhibitory control may be less adaptive for children who also have relatively high levels of negative emotionality. Findings are discussed in the context of cognitive overcontrol in understanding risk for internalizing behaviors before formal school entry.