Prenatal substance exposure, adverse childhood experiences and diagnosed mental and behavioral disorders - A longitudinal register-based matched cohort study in Finland
| Autor: | Niina-Maria Nissinen, Hanna Kahila, Ilona Autti-Rämö, Anne M. Koponen, Taisto Sarkola, Mika Gissler |
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| Přispěvatelé: | University of Helsinki, Department of Public Health, HUS Children and Adolescents, Children's Hospital, Lastenneurologian yksikkö, Clinicum, Department of Obstetrics and Gynecology, HUS Gynecology and Obstetrics, Helsinki University Hospital Area |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Register based
medicine.medical_specialty Health (social science) Youth IN-UTERO CHILDREN ALCOHOL SPECTRUM DISORDERS Article 03 medical and health sciences 0302 clinical medicine Matched cohort Medicine Adverse childhood experiences 030212 general & internal medicine lcsh:Social sciences (General) Adverse Childhood Experiences Psychiatry Mental and behavioral disorders ABUSE OUTCOMES 030505 public health business.industry Proportional hazards model Health Policy Medical record lcsh:Public aspects of medicine Public Health Environmental and Occupational Health FASD COCAINE EXPOSURE lcsh:RA1-1270 Mental health 3142 Public health care science environmental and occupational health 3. Good health Low birth weight PREGNANCY RISK-FACTORS lcsh:H1-99 HEALTH medicine.symptom 0305 other medical science business FOLLOW-UP Cohort study Prenatal substance exposure |
| Zdroj: | SSM-Population Health SSM: Population Health, Vol 11, Iss, Pp 100625-(2020) |
| Popis: | Both prenatal substance exposure (PSE, alcohol/drugs) and experiences during the first years of life have powerful effects on brain development. However, only a few studies have investigated the combined effect of PSE and adverse childhood experiences (ACEs) on mental and behavioral disorders among exposed adolescents and adults. This longitudinal register-based cohort study 1) compared the nature and extent of diagnosed mental and behavioral disorders among youth with PSE and matched unexposed controls, and 2) investigated the influence of PSE, health in infancy and ACEs (maternal risk factors and out-of-home care, OHC) on diagnoses of mental and behavioral disorders. The data consisted of 615 exposed youth aged 15–24 years and 1787 matched unexposed controls. Data from hospital medical records and nine registers were merged for the analysis. Descriptive analysis methods and Cox regression were used. The results showed that the prevalence of mental and behavioral disorders was twice as high among exposed compared with controls. The highest levels of mental and behavioral disorders and ACEs were found among exposed with at least one OHC episode. The difference in the risk of mental and behavioral disorders between exposed and controls diminished after controlling for the effect of ACEs. Low birth weight, maternal risk factors, and OHC were the strongest predictors of mental and behavioral disorders. The results suggest that PSE alone does not explain poorer mental health among exposed youth. Risk factors accumulate, and low birth weight and ACEs are strongly associated with increased risk of mental and behavioral disorders. Highlights • Mental health problems are common in youth with prenatal substance exposure (PSE). • Adverse childhood experiences (ACEs) accumulate among youth with PSE. • PSE alone does not predict the high rate of mental and behavioral disorders. • Youths with PSE and many ACEs had the highest risk of mental health problems. |
| Databáze: | OpenAIRE |
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