Differences between Dropouts and Active Participants in a Pediatric Clinic for Substance Abuse Mothers

Abstract

We compared the maternal and birth characteristics of 87 first-year dropouts with 103 active participants of a pediatric clinic which provides long-term follow-up care to offspring exposed in utero to substance abuse mothers. The age, ethnicity, and marital status of the mother; the type of drug used during pregnancy; and the length, gender, number, and type of addiction problems of the newborn were not significantly different between the two groups. However, the dropouts differed significantly from the active participants in many other aspects. More dropout mothers received no prenatal care and did not have children at home at the time of the present birth. More of them were smokers; had gonorrhea, heart, and kidney problems; and had infections complicating their pregnancy. The dropout newborns were found to have lower birthweight and shorter gestation. These clinical parameters defined a suboptimal group of mothers and children requiring more attention and care. The findings also alert investigators of long-term follow-up studies to be aware of basic differences between nonparticipants and participants.

Dropping Out of Maternal and Child Home Visits

“…The finding that women with fewer children were more likely to drop out appears to be inconsistent with Bradley and Martin's (1994) findings regarding women continuing with prenatal care coordination and Chan et al. (1986) for mothers attending a pediatric clinic for infants exposed in utero to drugs.…”

“…There was no difference in socioeconomic status, birth weights, infant neurobiologic score, stress in caring for the infant, coping style, or psychological symptoms. A study of dropouts of a follow‐up pediatric clinic for infants exposed in utero to drugs found that dropout mothers were less likely to receive prenatal care and have other children at home and were more likely to be smokers with histories of gonorrhea, heart and kidney problems, and infections (Chan, Wingert, Wachsman, Schuetz, & Rogers, 1986). The infants of the dropout mothers were born weighing less after shorter pregnancies than the enrolled mothers' infants.…”

Effects of Three Levels of Early Intervention Services on Children Prenatally Exposed to Cocaine

“…Documented prenatal factors that might affect child development are poor nutrition and health, inadequate prenatal medical care, maternal smoking, and poly-drug use (Chan, Wingert, Wachsman, Schuetz, & Rogers, 1986;Hulse, English, Milne, Holman, & Bower, 1997). Cocaine exposure correlates with low birth weight, which in turn is associated with later developmental delays (Bendersky & Lewis, 1999;Hulse et al, 1997).…”

Effects of cocaine exposure on infant development: A review

“…These mothers are the "best" of the low-income portion of the drug-using population in terms of health, stability, and personal motivation. This point is documented in one study which contrasted drug-using mothers who dropped out of pediatric care for their children with drug-using mothers who continued care (Chan, Wingert, Wachsman, Schuetz, & Rogers, 1986). The dropouts were more likely to have received no prenatal care; to have no other children at home; to be smokers; to have gonorrhea, heart and kidney problems, and infections complicating their pregnancies; and to have infants with lower birth weight and shorter gestation.…”