Early Intervention Referral and Enrollment Among Infants with Neonatal Abstinence Syndrome
| Autor: | Rachana Singh, Peter D. Friedmann, Emily Feinberg, Donna Wilson, JoAnna K. Leyenaar, Elizabeth Peacock-Chambers, Sheila Foss, Paul Visintainer |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Pediatrics medicine.medical_specialty Referral Mothers Logistic regression Young Adult 03 medical and health sciences 0302 clinical medicine Pregnancy Early Medical Intervention 030225 pediatrics Developmental and Educational Psychology medicine Humans 0501 psychology and cognitive sciences Referral and Consultation Retrospective Studies business.industry Public health 05 social sciences Infant Newborn Retrospective cohort study Odds ratio Opioid-Related Disorders medicine.disease Confidence interval Hospitalization Pregnancy Complications Psychiatry and Mental health Foster care Massachusetts Pediatrics Perinatology and Child Health Female business Neonatal Abstinence Syndrome 050104 developmental & child psychology |
| Zdroj: | Scopus-Elsevier |
| ISSN: | 0196-206X |
| DOI: | 10.1097/dbp.0000000000000679 |
| Popis: | OBJECTIVE To identify factors associated with referral and enrollment in early intervention (EI) for infants with neonatal abstinence syndrome (NAS). METHODS We conducted a retrospective cohort study of 256 infants born with NAS (2006-2013) at a tertiary care hospital in (Springfield), Massachusetts, linking maternal-infant birth hospitalization records with Department of Public Health EI records. We calculated the percent of infants retained at each step in the EI enrollment process over the first 3 years of life. We conducted separate multivariable logistic regression analyses to identify factors associated with EI referral and enrollment. RESULTS Among mothers, 82% received medication-assisted treatment at delivery, 36% endorsed illicit drug use during pregnancy, and 76% retained custody of their child at discharge. Among infants, 77% were referred to EI and 48% were enrolled in services. Of infants discharged to biological parents, 81% were referred to EI versus 66% of infants discharged to foster care (p ≤ 0.05); this difference persisted in multivariable analysis [adjusted odds ratio, 2.30; 95% confidence interval (CI), 1.09-4.86]. Infants in the highest tertile for length of stay had 2.70 times the odds of EI enrollment (95% CI, 1.37-5.31). CONCLUSION Fewer than half of the eligible infants with NAS were enrolled in EI services. Discharge to a biological parent and longer hospital stay had the strongest associations with EI referral and enrollment, respectively. Efforts to improve EI referral rates during the birth hospitalization, particularly among infants discharged into foster care, and close follow-up for infants with shorter hospital stays would enhance the developmental supports for this vulnerable population. |
| Databáze: | OpenAIRE |
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