Considerations and Determinants of Discharge Decisions among Prenatal Substance Exposed Infants

Abstract

Limited research has examined a comprehensive set of predictors when evaluating discharge placement decisions for infants exposed to substances prenatally. Using a previously validated medical record data extraction tool, the current study examined prenatal substance exposure, infant intervention (i.e., pharmacologic, or non-pharmacologic), and demographic factors (e.g., race and ethnicity and rurality) as predictors of associations with discharge placement in a sample from a resource-poor state ( N = 136; 69.9% Non-Hispanic White). Latent class analysis (LCA) was used to examine whether different classes emerged and how classes were differentially related to discharge placement decisions. Logistic regressions were used to determine whether each predictor was uniquely associated with placement decisions. Results of the LCA yielded a two-class solution comprised of (1) a Low Withdrawal Risk class, characterized by prenatal exposure to substances with low risk for neonatal abstinence syndrome (NAS) and non-pharmacologic intervention, and (2) a High Withdrawal Risk class, characterized by a high risk of NAS and pharmacologic intervention. Classes were not related to discharge placement decisions. Logistic regressions demonstrated that meth/amphetamine use during pregnancy was associated with greater odds of out of home placement above other substance types. Future research should replicate and continue examining the clinical utility of these classes.

The paper chase: A team science training exercise.

“…Thus, to have a successful collaboration, the Paper Chase combined these two foci. The data set used by this team allowed for this overlap by addressing substance use during pregnancy and child development outcomes (see Gissandaner et al, 2023). Once trainees agreed to the collaboration, several meetings were scheduled to identify the strengths and weaknesses of the team, develop an outline of the article, and brainstorm methodological and analytical approaches to appropriately address the team’s research questions.…”

“…Time from the writing day to initial submission was 2 months for both teams. For both teams, time from the writing day to acceptance for publication was 10–12 months and involved multiple sets of revisions and resubmissions (Gissandaner et al, 2023; Penner et al, 2022).…”