Maternal Substance Use Disorders and Infant Outcomes in the First Year of Life among Massachusetts Singletons, 2003-2010

Hwang, Sung Kwan; Diop, Hafsatou; Liu, Chia-ling; Yu, Qi; Babakhanlou‐Chase, Hermik; Cui, Xiaohui; Kotelchuck, Milton

doi:10.1016/j.jpeds.2017.08.045

Cited by 31 publications

(22 citation statements)

References 21 publications

(21 reference statements)

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“…Infants in the top tertile for length of hospital stay were most likely to enroll in EI, even after adjusting for confounders. Stability of maternal recovery during the birth hospitalization (e.g., maternal enrollment in medication-assisted treatment, abstinence from illicit drugs in pregnancy) can affect clinical outcomes for substanceexposed infants 30,31 ; however, our study did not find any association between stability of recovery and ultimate EI enrollment. Although the reason for this lack of association requires future study, these results suggest that other factors, possibly related to perceived need for services, may drive voluntary enrollment of infants with NAS as has been the case in other populations.…”

Section: Discussioncontrasting

confidence: 92%

Early Intervention Referral and Enrollment Among Infants with Neonatal Abstinence Syndrome

Peacock-Chambers

Leyenaar

Foss

et al. 2019

J Dev Behav Pediatr

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Objective: To identify factors associated with referral and enrollment in early intervention (EI) for infants with neonatal abstinence syndrome (NAS). Methods: We conducted a retrospective cohort study of 256 infants born with NAS (2006-2013) at a tertiary care hospital in (Springfield), Massachusetts, linking maternal-infant birth hospitalization records with Department of Public Health EI records. We calculated the percent of infants retained at each step in the EI enrollment process over the first 3 years of life. We conducted separate multivariable logistic regression analyses to identify factors associated with EI referral and enrollment. Results: Among mothers, 82% received medication-assisted treatment at delivery, 36% endorsed illicit drug use during pregnancy, and 76% retained custody of their child at discharge. Among infants, 77% were referred to EI and 48% were enrolled in services. Of infants discharged to biological parents, 81% were referred to EI versus 66% of infants discharged to foster care (p ≤ 0.05); this difference persisted in multivariable analysis [adjusted odds ratio, 2.30; 95% confidence interval (CI), 1.09-4.86]. Infants in the highest tertile for length of stay had 2.70 times the odds of EI enrollment (95% CI, 1.37-5.31). Conclusion: Fewer than half of the eligible infants with NAS were enrolled in EI services. Discharge to a biological parent and longer hospital stay had the strongest associations with EI referral and enrollment, respectively. Efforts to improve EI referral rates during the birth hospitalization, particularly among infants discharged into foster care, and close follow-up for

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Section: Discussioncontrasting

confidence: 92%

Early Intervention Referral and Enrollment Among Infants with Neonatal Abstinence Syndrome

Peacock-Chambers

Leyenaar

Foss

et al. 2019

J Dev Behav Pediatr

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“…Indeed, ischemic disease processes-with impaired trophoblast invasion and deficient remodeling of the maternal spiral arteries-as well as an altered inflammatory response may represent common denominators in the mechanisms underlying many ELCs detected in our sample (52,55,57). Preeclampsia and IUGR are in fact frequently linked with many other ELCs detected in our samples (58)(59)(60)(61), and they are themselves classic severe ELCs (severity level ≥4 on the McNeil-Sjöström scale) that have been associated with increased risk for schizophrenia, and also where the primary affected cells have been isolated and studied ex vivo (3,62,63). Since both preeclampsia and IUGR are ELCs attributed to a shallow invasion of the uterine interstitial compartment from cytotrophoblasts (3,(62)(63)(64), we also analyzed a dataset of cytotrophoblasts cultured ex vivo under conditions of different invasiveness.…”

Section: Methodsmentioning

confidence: 74%

Placental genomic risk scores and early neurodevelopmental outcomes

Ursini

Punzi

Langworthy

et al. 2021

Proc. Natl. Acad. Sci. U.S.A.

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Tracing the early paths leading to developmental disorders is critical for prevention. In previous work, we detected an interaction between genomic risk scores for schizophrenia (GRSs) and early-life complications (ELCs), so that the liability of the disorder explained by genomic risk was higher in the presence of a history of ELCs, compared with its absence. This interaction was specifically driven by loci harboring genes highly expressed in placentae from normal and complicated pregnancies [G. Ursini et al., Nat. Med. 24, 792–801 (2018)]. Here, we analyze whether fractionated genomic risk scores for schizophrenia and other developmental disorders and traits, based on placental gene-expression loci (PlacGRSs), are linked with early neurodevelopmental outcomes in individuals with a history of ELCs. We found that schizophrenia’s PlacGRSs are negatively associated with neonatal brain volume in singletons and offspring of multiple pregnancies and, in singletons, with cognitive development at 1 y and, less strongly, at 2 y, when cognitive scores become more sensitive to other factors. These negative associations are stronger in males, found only with GRSs fractionated by placental gene expression, and not found in PlacGRSs for other developmental disorders and traits. The relationship of PlacGRSs with brain volume persists as an anlage of placenta biology in adults with schizophrenia, again selectively in males. Higher placental genomic risk for schizophrenia, in the presence of ELCs and particularly in males, alters early brain growth and function, defining a potentially reversible neurodevelopmental path of risk that may be unique to schizophrenia.

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“…38,39 Preconception and pregnancy are sensitive periods in which substance use, and specifically opioid misuse, have dramatic detrimental effects: women who use opioids during pregnancy have increased rates of preterm birth, and their infants are more likely to be born low birthweight or growth restricted and have neonatal abstinence syndrome, which increases their risk of morbidities in the first year of life including feeding problems, infections, and poor neurologic development and function. [40][41][42] SUDs often coexist with other social factors that contribute to health disparities in women, such as low socioeconomic and demographic status, high levels of psychological stress, 43 and nutritional insecurity [44][45][46] ; each of these alone are known to program poor pregnancy and infant outcomes. In their paper, Miller et al 47 address the growing opioid misuse crisis in a Canadian population of pregnant women and their infants.…”

Section: Vulnerable and At-risk Populationsmentioning

confidence: 99%

A Canadian perspective on the developmental origins of health and disease: understanding the past as a way forward

Connor

Bourque

Weaver

2019

J Dev Orig Health Dis

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More than two decades ago, David Barker published a landmark paper describing the fetal origins of adult disease hypothesis, which posited that suboptimal conditions during pregnancy 'program' the fetus for the development of chronic diseases in adulthood. 1 The conceptual underpinnings of the fetal programming hypothesis were built on a series of epidemiological studies linking indices of adversity in early life with cardiovascular mortality in later life. In the ensuing decade, this concept stimulated a great deal of interest and work from research groups all around the world, and this global effort culminated in the first World Congress on the Fetal Origins of Adult Disease, convened in 2001 in Mumbai, India. In 2004, following the second World Congress held in Brighton, UK, the society adopted the title of 'Developmental Origins of Health and Disease' (DOHaD), to 'recognize the broader scope of developmental cues, extending from the oocyte to the infant and beyond, and the concepts that early life environments have widespread consequences for later health.' 2 The first meeting of the DOHaD Society was held in Toronto in 2005, highlighting Canada as a prominent entity in the field. In 2016, DOHaD Canada became a recognized chapter of the International DOHaD Society. The Inaugural Meeting for DOHaD Canada, held in Montebello, Québec in 2017, was a resounding success, attracting leading investigators, clinicians and traineesa testament to Canada's engagement in the field. Canada continues to uphold its commitment to DOHaD-related research; with a membership of almost 200 investigators and trainees, DOHaD Canada will host its third meeting in Mont-Tremblant, Québec in February of 2019. The meeting will focus on the country's research strengths: epigenetics and omics mechanisms underlying DOHaD, vulnerable populations, and solution-oriented research and policy. DOHaD Canada's mission is to be a globally connected network focused on creating, translating and communicating the latest knowledge on early development to improve the immediate and long-term health of Canadians, and to promote maternal-child health and well-being on a global platform. The Society engages in social, biological, clinical and economic research focusing on: (i) how environmental factors during the early life period (preconception, childhood and adolescence) interact with development to place individuals on trajectories that impact lifelong health, learning and social functioning; and (ii) development of strategies that prevent or reverse negative lifecourse outcomes, promoting health and wellness for all Canadians. Within its broad mandate, DOHaD Canada has made a concerted effort to address the unique health needs borne of its diverse populations, storied cultural heritage, expansive geography and varied climates. As a country, Canada ranks among the highest in international indices of civil liberties, quality of life, education and government transparency. Canadians take immense pride in the nation's commitment to multilateralism and intern...

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Maternal Substance Use Disorders and Infant Outcomes in the First Year of Life among Massachusetts Singletons, 2003-2010

Cited by 31 publications

References 21 publications

Early Intervention Referral and Enrollment Among Infants with Neonatal Abstinence Syndrome

Early Intervention Referral and Enrollment Among Infants with Neonatal Abstinence Syndrome

Placental genomic risk scores and early neurodevelopmental outcomes

A Canadian perspective on the developmental origins of health and disease: understanding the past as a way forward

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