Prenatal Cocaine Exposure and Child Welfare Outcomes

Abstract

This study examines the relationship between prenatal cocaine exposure and child welfare outcomes. Seventy-six infants positive for cocaine at birth were matched to 76 negative infants. With prenatal care and maternal use of alcohol and tobacco controlled, cocaine-exposed infants had significant decrements in birth weight, length, head circumference, and depressed 5-min Apgar scores. This confirmed the health risk of prenatal cocaine exposure for the sample. Three-year follow-up data were obtained from the State Central Register and foster care records. Adjusting for prior maternal involvement with child welfare services the study groups did not differ in incidents of child maltreatment or foster care placement. These findings suggest that prenatal cocaine exposure is not a marker for abusive parenting. However, from the perspective of a cumulative risk model, the identification of cocaine-exposed infants at birth can form the starting point for the development of appropriate diagnostic and follow-up services for mother and child.

Ethical Issues and Addiction

“…However, isolated maternal cocaine use during pregnancy is not a useful marker for identifying infants at risk for abusing parenting. 27,34,37 …”

“…It is highly likely that the addicted mother, who in many instances is a single parent, without adequate financial resources, family support, and parenting skills, may have satisfying her addiction as her primary goal rather than providing for the needs of her children. Factors associated with substance abuse, such as depression, criminality, poverty, prior physical and emotional abuse, and family violence, 27,34 increase this likelihood. However, isolated maternal cocaine use during pregnancy is not a useful marker for identifying infants at risk for abusing parenting.…”

“…It is of note that in a small study of 76 children that examined the relationship between prenatal cocaine exposure and child welfare outcomes, prenatal cocaine exposure was not found to be a marker for abusive parenting after adjustment for prior maternal involvement with the child welfare system. 34 Others hold the view that a pregnant woman's autonomy should always override the rights of her fetus, provided the woman is fully informed and is competent to make a decision. 35 This forms the argument of those proponents who believe that a fetus has no moral status.…”

HIV-Infected Mothers' Foci of Concern During the Viral Testing of Their Infants

“…It is unclear what HIV-infected pregnant and postpartum women who are actively drug-using might identify as their most worrisome issues. In addition, mothers with active drug use problems are often separated from their infants for weeks, months, or years (Doris, Meguid, Thomas, Blatt & Eckenrode, 2006;McMahon, 1997). Depending on the circumstances of the separation, some of these mothers may have different patterns of concern from the women in this study.…”

Linking illicit substance misuse during pregnancy and child abuse: what is the quality of the evidence?

“…; Kelley ; Doris et al . ). Studies with longer follow‐up periods increase the risk and opportunity for child protection involvement.…”