可卡因暴露新生儿的监护：出院决策的决定因素。
Custody of cocaine-exposed newborns: determinants of discharge decisions.
作者信息
Neuspiel D R, Zingman T M, Templeton V H, DiStabile P, Drucker E
机构信息
Department of Epidemiology and Social Medicine, Albert Einstein College of Medicine, Bronx, NY.
出版信息
Am J Public Health. 1993 Dec;83(12):1726-9. doi: 10.2105/ajph.83.12.1726.
OBJECTIVES
Maternal cocaine use is a leading grounds for newborn foster placement. This study was initiated to investigate the factors that predict custody status of infants born to substance-abusing women.
METHODS
A retrospective cohort design was used to study the correlates of discharge custody decisions for 99 consecutive infants testing positive for cocaine in a public hospital.
RESULTS
The population was 49% Black, 40% Hispanic, and 11% other or unknown. Custody at discharge was to mothers (38%), other family members (25%), or agency foster care (36%). Placement outside the family was greater when mothers had prior child welfare records, in Blacks vs others, with no prenatal care, and when mothers were younger at their first delivery or older at the index birth. Denial of custody to the mother was higher with prior child welfare involvement, in Blacks, and when the mother did not live in her own home. Both models also controlled for parity, child sex, and birthweight.
CONCLUSIONS
Earlier involvement with child welfare authorities, race, and other factors predict continued separation of mothers and children at newborn discharge, suggesting the need to reexamine current policies and practices.
目的
母亲使用可卡因是新生儿被寄养的主要原因。本研究旨在调查预测药物滥用妇女所生孩子监护状态的因素。
方法
采用回顾性队列设计，研究一家公立医院中99名连续可卡因检测呈阳性的婴儿出院监护决定的相关因素。
结果
研究对象中49%为黑人，40%为西班牙裔，11%为其他或不明种族。出院时监护权归属母亲的占38%，归属其他家庭成员的占25%，归属机构寄养的占36%。母亲有儿童福利记录前科、黑人相较于其他种族、未接受产前护理、首次分娩时年龄较小或本次分娩时年龄较大时，孩子被安置在家庭外的比例更高。母亲有儿童福利记录前科、为黑人以及母亲不住在自己家中时，母亲被剥夺监护权的比例更高。两种模型均对产次、孩子性别和出生体重进行了控制。
结论
更早地与儿童福利机构接触、种族及其他因素可预测新生儿出院时母婴持续分离，这表明有必要重新审视现行政策和做法。
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