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. 2024 May;43(4):823-847.
doi: 10.1111/dar.13835. Epub 2024 Mar 28.

The burden of prenatal and early life maternal substance use among children at risk of maltreatment: A systematic review

Madeleine Powell  1   2 , Rhiannon Pilkington  3 , Bianca Varney  2 , Alys Havard  1   2 , John Lynch  3   4 , Timothy Dobbins  2 , Ju Lee Oei  5   6 , Tasnia Ahmed  2 , Kathleen Falster  2
Affiliations

The burden of prenatal and early life maternal substance use among children at risk of maltreatment: A systematic review

Madeleine Powell et al. Drug Alcohol Rev. 2024 May.

Abstract

Issues: Although maternal substance use is a known risk factor for child maltreatment, evidence on the scale of substance use is needed to inform prevention responses. This systematic review synthesised prevalence estimates of maternal substance use during pregnancy and early life among children at risk of maltreatment. Ovid, Pubmed, CINAHL, PsychInfo and ProQuest databases were searched. We included observational studies that sampled children at risk of maltreatment in high-income countries and reported information on maternal substance use during pregnancy and/or the child's first year of life. We extracted study characteristics and data to calculate prevalence, assessed risk of bias and conducted a narrative synthesis; there were insufficient comparable populations or outcomes to quantitatively synthesise results.

Key findings: Thirty five of 14,084 titles were included. Fifteen studies had adequately sized and representative samples to estimate prevalence. Maternal substance use prevalence ranged from 2.4% to 40.6%. Maternal substance use was highest among infants referred to child protection at birth (40.6%) and children in out-of-home care (10.4% to 37.2%). Prevalence was higher when studies defined substance use more broadly and when maternal substance use was ascertained from both child and mother records.

Implications: Supportive, coordinated responses to maternal substance use are needed from health and child protection services, spanning alcohol and other drug treatment, antenatal and postnatal care.

Conclusions: Prenatal and early life maternal substance use is common among child maltreatment populations, particularly among younger children and those with more serious maltreatment.

Keywords: child maltreatment; epidemiology; intimate partner violence; prevalence; substance use.

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References

REFERENCES

    1. Green MJ, Tzoumakis S, McIntyre B, Kariuki M, Laurens KR, Dean K, et al. Childhood maltreatment and early developmental vulnerabilities at age 5 years. Child Dev. 2018;89:1599–1612.
    1. Gilbert R, Spatz Widom C, Browne K, Fergusson D, Webb E, Janson S. Burden and consequences of child maltreatment in high‐income countries. Lancet. 2009;373:68–81.
    1. Falster K, Hanly M, Pilkington R, Eades S, Stewart J, Jorm L, et al. Cumulative incidence of child protection services involvement before age 5 years in 153 670 Australian children. JAMA Pediatr. 2020;174:995–997.
    1. Rouland B, Vaithianathan R. Cumulative prevalence of maltreatment among New Zealand children, 1998‐2015. Am J Public Health. 2018;108:511–513.
    1. Kim H, Wildeman C, Jonson‐Reid M, Drake B. Lifetime prevalence of investigating child maltreatment among US children. Am J Public Health. 2017;107:274–280.

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