Folkhälsan Research Center, Helsinki, Finland; Tampere University, Faculty of Social Sciences, Health Sciences Unit, Tampere, Finland.
THL Finnish Institute for Health and Welfare, Information Services Department, Helsinki, Finland; Karolinska Institute, Department of Neurobiology, Care Sciences and Society, Stockholm, Sweden; University of Turku, Research Centre for Child Psychiatry, Turku, Finland.
J Adolesc. 2021 Jan;86:15-27. doi: 10.1016/j.adolescence.2020.11.006. Epub 2020 Nov 29.
The dual impact of prenatal substance exposure (i.e. alcohol/drugs) and adverse postnatal caregiving environment on offspring secondary education completion is an understudied research area. The aim was to investigate the influence of childhood adversities, out-of-home care, and offspring's mental and/or behavioural disorders on secondary education completion among prenatally exposed offspring in comparison to matched unexposed offspring.
This is a longitudinal register-based matched cohort study in Finland including offspring with a history of prenatal substance exposure and a matched unexposed cohort. The study sample included 283 exposed and 820 unexposed offspring aged 18-23 years.
The results showed a time lag in secondary education completion and lower educational attainment overall among exposed compared with unexposed (37.8% vs. 51.0%, respectively). The results from the multivariate logistic regression models showed that the differences in the secondary education completion between exposed and unexposed were diminished in the presence of covariates. A cumulative childhood adversity score and out-of-home care were not associated with secondary education completion in the multivariate models, whereas the different domains of offspring's mental and/or behavioural disorders including psychiatric disorders (AOR 0.65, 95% CI 0.45-0.96), neuropsychological disorders (AOR 0.35, 95% CI 0.23-0.54) and dual psychiatric and neuropsychological disorder (AOR 0.29, 95% CI 0.18-0.48) showed an independent negative effect on secondary education completion.
Inferior educational outcomes may not be directly linked with prenatal substance exposure but may rather reflect the extent of evolving offspring's mental and/or behavioural disorders over time influenced by childhood adversities.
产前物质暴露（即酒精/毒品）和不良的产后照护环境对后代完成中等教育的双重影响是一个研究不足的领域。本研究旨在调查儿童逆境、家庭外照顾以及后代的精神和/或行为障碍对有产前物质暴露史的后代与匹配的未暴露后代完成中等教育的影响。
这是一项在芬兰进行的基于登记的纵向匹配队列研究，包括有产前物质暴露史的后代和匹配的未暴露队列。研究样本包括 283 名暴露组和 820 名未暴露组的 18-23 岁的后代。
研究结果显示，与未暴露组相比，暴露组在完成中等教育方面存在时间滞后，整体教育程度较低（分别为 37.8%和 51.0%）。多变量逻辑回归模型的结果表明，在存在协变量的情况下，暴露组和未暴露组在完成中等教育方面的差异有所缩小。累积儿童逆境评分和家庭外照顾与多变量模型中的中等教育完成无关，而后代的精神和/或行为障碍的不同领域，包括精神障碍（AOR 0.65，95%CI 0.45-0.96）、神经心理障碍（AOR 0.35，95%CI 0.23-0.54）和双重精神和神经心理障碍（AOR 0.29，95%CI 0.18-0.48），对中等教育完成有独立的负面影响。
较差的教育结果可能与产前物质暴露没有直接联系，而可能反映了随着时间的推移，后代的精神和/或行为障碍的发展程度，这些障碍受到儿童逆境的影响。
