Impact of Plans of Safe Care on Prenatally Substance Exposed Infants
- PMID: 34699908
- PMCID: PMC8792271
- DOI: 10.1016/j.jpeds.2021.10.032
Impact of Plans of Safe Care on Prenatally Substance Exposed Infants
Abstract
Objective: To assess the impact of recent federal statute changes mandating child welfare-based Plan of Safe Care (POSC) supportive programming and community-based linkages to treatment providers, resources, and services for families of infants affected by prenatal substance exposure (IPSE).
Study design: Retrospective review of Delaware's statewide child welfare case registry data for IPSE birth notifications and subsequent hotline reports for serious physical injury/fatality concerns from November 1, 2018-October 31, 2020. Abstracted variables included IPSE sex, substance exposure type, family characteristics (maternal personal child welfare history or mental health diagnosis, treatment engagement), and POSC referrals.
Results: Of 1436 IPSE, 1347 (93.8%) had POSC support. Most IPSE (67.2%) had exposure to single substance types prenatally. Nearly 90% avoided out-of-home placement. Nearly one-fourth of mothers delivered a prior IPSE; 40% of mothers had personal histories of childhood protective services involvement. Also, 43.5% of mothers and 9.1% of fathers were referred to community-based resources, including substance use, mental health treatment, parenting classes, and home visiting nursing. Nearly 58% of IPSE were referred for pediatric/developmental assessment. Notably, 0.82% (11 out of 1347) of IPSE with POSC sustained serious physical or fatal injury.
Conclusions: POSC promote supportive, potentially protective linkages to community-based programming for IPSE and their families.
Keywords: child welfare; drug endangered child; in-utero substance exposure; maternal substance use disorder; maternal-infant health; neonatal abstinence syndrome; neonatal opioid withdrawal syndrome.
Copyright © 2021 Elsevier Inc. All rights reserved.
Similar articles
-
Novel Implementation of State Reporting Policy for Substance-Exposed Infants.Hosp Pediatr. 2022 Oct 1;12(10):841-848. doi: 10.1542/hpeds.2022-006562. Hosp Pediatr. 2022. PMID: 36093638 Free PMC article.
-
Factors Associated with Child-Welfare Involvement among Prenatally Substance-Exposed Infants.J Pediatr. 2020 Jul;222:35-44.e1. doi: 10.1016/j.jpeds.2020.03.036. Epub 2020 May 14. J Pediatr. 2020. PMID: 32418814 Free PMC article.
-
Estimating the incidence of substance exposed newborns with child welfare system involvement.Child Abuse Negl. 2024 Mar;149:106629. doi: 10.1016/j.chiabu.2023.106629. Epub 2024 Jan 16. Child Abuse Negl. 2024. PMID: 38232502
-
Interventions and programs that support the health and development of infants with prenatal substance exposure in foster care: a scoping review.JBI Evid Synth. 2021 Aug;19(8):1844-1886. doi: 10.11124/JBIES-20-00071. JBI Evid Synth. 2021. PMID: 33993147 Review.
-
Foster families who care for infants with prenatal drug exposure: support during the transition from NICU to home.Neonatal Netw. 2004 Nov-Dec;23(6):33-41. doi: 10.1891/0730-0832.23.6.33. Neonatal Netw. 2004. PMID: 15612419 Review.
Cited by
-
"The Problem's Bigger than We Are": Understanding How Local Factors Influence Child Welfare Responses to Substance Use in Pregnancy, A Qualitative Study.Child Welfare. 2023;101(2):193-224. Child Welfare. 2023. PMID: 38784918 Free PMC article.
-
Family Care Plans for Infants with Prenatal Substance Exposure.Child Welfare. 2023;101(2):169-192. Child Welfare. 2023. PMID: 38784917 Free PMC article.
-
Improving health and well-being for infants with prenatal substance exposure.Curr Probl Pediatr Adolesc Health Care. 2024 Feb;54(2):101572. doi: 10.1016/j.cppeds.2024.101572. Epub 2024 Mar 1. Curr Probl Pediatr Adolesc Health Care. 2024. PMID: 38431453
-
Exploring Child Welfare Practices to Care for Children with Prenatal Substance Exposure.Child Welfare. 2023 Sep 1;101(2):141-168. Child Welfare. 2023. PMID: 38021378 Free PMC article.
-
Infant and Pre-birth Involvement With Child Protection Across Australia.Child Maltreat. 2023 Nov;28(4):608-620. doi: 10.1177/10775595231186647. Epub 2023 Jun 29. Child Maltreat. 2023. PMID: 37386757 Free PMC article.
References
-
- Substance Abuse and Mental Health Services Administration. (2018). Key substance use and mental health indicators in the United States: results from the 2017 National Survey on Drug Use and Health. [updated 2018; cited 2021 Apr 30]. Available from: https://www.samhsa.gov/data/sites/default/files/cbhsqreports/NSDUHFFR201...
-
- Jansson LM. Infants of mothers with substance use disorder. [updated 2020; cited 2021 May 18]. In: Garcia-Prats JA, Kim MS, eds. UpToDate. https://www.uptodate.com/contents/infants-of-mothers-with-substance-use-...
-
- Substance Abuse and Mental Health Services Administration. Mental health and substance use disorders. [updated 2020 Apr 30; cited 2020 Oct 4]. Available from: https://www.samhsa.gov/find-help/disorders
-
- ChildFocus, National Association of State Alcohol and Drug Abuse Directors (NASADAD), Children’s Defense Fund. Implementing the substance use disorder provisions of the Family First Prevention Services Act: a toolkit for child welfare and treatment stakeholders. [updated 2020 Oct 23; cited 2020 Dec 10]. Available from: https://familyfirstact.org/resources/implementing-substance-use-disorder...
-
- U.S. Department of Health and Human Services, Administration for Children and Families, Administration on Children, Youth and Families, Children’s Bureau. [updated 2020 Jan 15; cited 2021 Mar 16]. Child maltreatment 2019. Available from: https://www.acf.hhs.gov/cb/report/child-maltreatment-2019
