Partners for Our Children, University of Washington School of Social Work, Seattle, WA, United States.
Partners for Our Children, University of Washington School of Social Work, Seattle, WA, United States.
Child Abuse Negl. 2019 Feb;88:28-36. doi: 10.1016/j.chiabu.2018.11.001. Epub 2018 Nov 13.
A frequent response for prenatal substance exposure (PSE) is intervention by child protective services (CPS). Previous research has examined differences in reports to CPS regarding PSE by substance exposure and by maternal race. However, little is known regarding the frequency of immediate removals by CPS relating to PSE and maternal race.
We investigated hospital reports to CPS and CPS removals of PSE infants by using linked birth, hospital discharge, and CPS records for all children born in Washington State between 2006 and 2013 (N = 760,863). We identified PSE using diagnostic codes, calculated prevalence by substance type and maternal race, and tested for differences by interactions of race and substance using multinomial logistic regression.
Prevalence of PSE births varied by race with 8.1% of Native American, 2.8% of black, 1.9% of white, and 0.8% of Hispanic births diagnosed with PSE. Opioids was the most common type of PSE diagnosis at 48.2%. The majority of PSE infants (86.7%) were not removed by CPS but variations by substance type were observed. Of the interactions in the multinomial logistic regression model, only black infants exposed to alcohol were more likely to result in reports to CPS without removal than the referent group of white infants exposed to opioids.
Findings indicate that most infants diagnosed with PSE were not removed by CPS and minority PSE infants were not reported to CPS or removed by CPS more than white infants. Racial differences identified in the prevalence of PSE present opportunities for targeted prevention efforts.
产前物质暴露（PSE）的常见反应是儿童保护服务（CPS）的干预。先前的研究已经研究了物质暴露和母亲种族对 CPS 关于 PSE 的报告差异。然而，关于与 PSE 和母亲种族有关的 CPS 立即搬迁的频率知之甚少。
我们通过使用链接的出生、医院出院和 CPS 记录，调查了所有 2006 年至 2013 年期间在华盛顿州出生的儿童（N=760863）的 CPS 向 CPS 报告和 PSE 婴儿的 CPS 搬迁情况。我们使用诊断代码识别 PSE，按物质类型和母亲种族计算患病率，并使用多项逻辑回归测试种族和物质相互作用的差异。
PSE 出生的患病率因种族而异，其中 8.1%的美洲原住民、2.8%的黑人、1.9%的白人以及 0.8%的西班牙裔出生时被诊断为 PSE。阿片类药物是最常见的 PSE 诊断类型，占 48.2%。大多数 PSE 婴儿（86.7%）未被 CPS 带走，但观察到了不同物质类型的差异。在多项逻辑回归模型的交互作用中，只有暴露于酒精的黑人婴儿比暴露于阿片类药物的白人婴儿更有可能导致 CPS 报告而无需带走。
研究结果表明，大多数被诊断为 PSE 的婴儿没有被 CPS 带走，少数 PSE 婴儿没有被 CPS 报告或比白人婴儿更不可能被 CPS 带走。PSE 患病率中的种族差异为有针对性的预防工作提供了机会。
