Neurobehavioral disorders among children born to mothers exposed to illicit substances during pregnancy.

Autor: Chen VC; School of Medicine, Chang Gung University, Taoyuan, Taiwan. cch1966@gmail.com.; Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi, Taiwan. cch1966@gmail.com., Lee CT; Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan., Wu SI; Department of Medicine, Mackay Medical College, Taipei, Taiwan. t140@mmc.edu.tw.; Department of Psychiatry and Suicide Prevention Center, Mackay Memorial Hospital, Zhongshan District, Section 2, Zhongshan North Road, No. 92, Taipei, 104, Taiwan. t140@mmc.edu.tw., Gossop M; National Addiction Centre, Institute of Psychiatry, King's College London, London, UK.
Jazyk: angličtina
Zdroj: BMC medicine [BMC Med] 2024 Dec 18; Vol. 22 (1), pp. 581. Date of Electronic Publication: 2024 Dec 18.
DOI: 10.1186/s12916-024-03762-9
Abstrakt: Background: Exposure to illicit substances during pregnancy may have long-term impacts on children's neurodevelopment. This study explores subsequent risks for intellectual disability, autistic disorders, and attention deficit and hyperactivity disorders in children born to mothers exposed to illicit substances before or during pregnancy.
Methods: We identified women with illicit drug use by linking the police records from the "Substance Abuse Control Databases" and Taiwan Birth Registration and Birth Notification records from 2004 to 2014. Children whose mothers that had exposed to illicit substances during pregnancy identified from the police records were the "substance-exposed cohort." A 1:1 ratio exact-matched comparison cohort based on child's gender, child's birth year, mother's birth year, and child's first use of the health insurance card, as well as a "propensity score (PS)-matched" comparison cohort of children born by substance-unexposed mothers, was established. Multivariate Cox regression analyses with competing risk models were performed.
Results: Higher incidences of intellectual disability (adjusted hazard ratio (aHR) = 2.41, 95% confidence interval (CI): 1.15-5.03) and attention deficit and hyperactivity disorder (ADHD) (aHR = 2.35, 95% CI: 1.63-3.28) were found in children prenatally exposed to illicit substances during pregnancy compared to exact-matched non-exposed cohorts. Adjusted risks of ADHD were significantly higher in mothers exposed to substances during pregnancy (aHR = 1.77 (1.42-2.21)) and before pregnancy (aHR = 1.43 (1.14-1.80)) compared to PS-matched unexposed cohorts after adjusting for covariates.
Conclusions: This is one of the first studies using large population-based data linked to criminal records to reveal increased risks of intellectual disability and ADHD in children with prenatal exposure to illicit substances compared to matched unexposed controls. Our results also highlight the importance of preventive measures and interventions for the well-being of both the mother and the child.
Competing Interests: Declarations. Ethics approval and consent to participate: This study linked the Household Registration files to obtain the mother’s basic demographic data, the National Health Insurance Research Database (the NHIRD, a population-based and comprehensive healthcare database that contains de-identified registration files and claims data from the National Health Insurance program in Taiwan) to obtain the mother’s and the child’s health and medical utilizations and medical expenses from emergency visits, outpatient and hospitalization records, the “Substance Abuse Control Database” that contained crime records for information on illicit substance uses in women, the Nation’s Birth Registration and Birth Notification files, and the Death Registration files. All personal information, including ID numbers and other data, was encrypted, ensuring no specific identifications could be obtained. The research team went into the Science Center, performing statistical analyses only on the data the Center provided by the Center’s regulations. Since no personal identifications are possible, informed consent was waived by the Institutional Review Board of National Taiwan Normal University (IRB number: 202002HM010). Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.
(© 2024. The Author(s).)
Databáze: MEDLINE
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