Care and supportive measures in school-aged children with prenatal substance exposure.

AIMS: Prenatal exposure to substances, including alcohol, opiates, and a number of illicit drugs, may have a negative impact on fetal development. Studies have shown that substance exposure can influence a child's neurodevelopment and the need for care and supportive measures. In this study, we aimed to investigate the care status and the level of supportive measures in school-aged children prenatally exposed to alcohol and other substances. METHODS: This study included children aged between 6 and 14 years who were referred to Haukeland University Hospital in Norway with developmental impairment and a history of prenatal substance exposure. Participants were classified according to their main prenatal exposure to either alcohol or other substances. Information on care status and supportive measures was obtained from medical records and participants' caregivers. We also compared the use of supportive measures for children placed into foster care before and after 1 year of age. RESULTS: A total of 111 (87% of 128 referrals) eligible children participated in the study. Of these 111 children, 96 (86%) were in foster care, of whom 29 (30%) were placed into foster care during their first year of life and 83 out of 90 (92%) had supportive measures, including reinforced foster care and school or social support. CONCLUSIONS: A high proportion of the sample lived in foster care and received supportive measures. Findings may reflect an increased need of care and support in school-aged children with prenatal substance exposure, highlighting the importance of awareness among caregivers and public agencies.

[Substitution treatment of drug addicts during pregnancy: consequences for the children?]. / Har legemiddelassistert rehabilitering i svangerskapet konsekvenser for barna?

BACKGROUND: Substitution treatment of opioid-dependent addicts was introduced in Norway in 1998. During the last 10 years, approximately 150 infants have been born to mothers taking part in this programme. MATERIAL AND METHODS: 10 mothers, who took part in the substitution treatment programme, gave birth to 15 infants at Haukeland University Hospital in the period 1999-2005. The infants were observed and monitored at the Department of Pediatrics, Haukeland University Hospital. RESULTS: During pregnancy, six of the infants were only exposed to opiates, i.e methadone or buprenorphine. Eight infants were also exposed to heroine, benzodiazepines or cannabis. As a group, these infants had lower birth weight than the national average. 14 of the 15 children developed neonatal abstinence syndrome (NAS), 10 needed treatment and two children died from sudden infant death syndrome (SIDS). Long-term follow-up showed that six of 13 children had normal psychomotor development, five had various degrees of delayed psychomotor development and two children had symptoms indicating a hyperkinetic disorder. Five children were in foster care. INTERPRETATION: Infants of women included in substitution treatment programmes for drug addicts are at high risk compared to infants of women without such addiction. For the newborn, NAS was a frequent complication. The study also showed that symptoms of hyperkinetic disorder and delayed psychomotor development were common. Children who had been exposed to opiates in combination with additional drugs seemed to have a high risk of delayed development and behaviour disorders. As they get older many were placed in foster care, despite well-coordinated, multidisciplinary treatment for the mother.

Symptoms Associated With Attention Deficit/Hyperactivity Disorder and Autism Spectrum Disorders in School-Aged Children Prenatally Exposed to Substances.

Prenatal exposure to substances may influence a child's neurodevelopment and impact on subsequent mental health. In a hospital-based population of school-aged children prenatally exposed to opiates and a number of illicit substances (n = 57), we evaluated mental health symptoms associated with attention deficit/hyperactivity disorder (ADHD) and autism spectrum disorders (ASD) using the Swanson, Nolan, and Pelham Questionnaire, revision IV (SNAP-IV) and the Autism Spectrum Screening Questionnaire (ASSQ) and compared the scores to a reference group which comprised children from the population-based Bergen Child Study (n = 171). Prenatally exposed children had significantly higher SNAP-IV scores associated with ADHD symptoms in both areas of inattention and hyperactivity/impulsivity and also reported a higher ASSQ score related to an increased number of symptoms associated with ASD, compared with the reference group. Of tested predictors of mental health outcomes in the exposed group, the intelligence quotient was a strong predictor of most mental health outcomes, and neonatal abstinence syndrome was a predictor of inattention. In conclusion, prenatally exposed children had more mental health symptoms associated with ADHD and ASD, compared with the reference group.

Mental Health in School-Aged Children Prenatally Exposed to Alcohol and Other Substances.

Prenatal exposure to substances can possibly influence a child's neurodevelopment and may impact on subsequent mental health. We investigated the mental health status of school-aged children referred to a pediatric hospital with a history of prenatal exposure to alcohol or other substances. Mental health was assessed using the Strengths and Difficulties Questionnaire and compared with a reference group. A total of 105 of 128 (82%) eligible children prenatally exposed to substances participated in the study, with 48 children exposed to alcohol and 57 to other substances. Strengths and Difficulties Questionnaire subscale mean scores, total difficulties scores, and total impact scores were statistically significantly higher in the group of exposed children, compared with the reference group. In this hospital-based population of school-aged children prenatally exposed to alcohol or other substances, the exposed group had an increased risk of mental health problems, compared with the reference group.