The physical and developmental outcomes of children whose mothers are substance abusers: Analysis of associated factors and the impact of early intervention

Anna Wai Fun Cheng; Hin Biu Chan; Lai Sheung Ip; Katy Kit Ying Wan; Ellen Lok Man Yu; Wa Keung Chiu; Pui Hong Chung; Eng Kiong Yeoh

doi:10.3389/fped.2022.1004890

The physical and developmental outcomes of children whose mothers are substance abusers: Analysis of associated factors and the impact of early intervention

Front Pediatr. 2022 Oct 20:10:1004890. doi: 10.3389/fped.2022.1004890. eCollection 2022.

Authors

Anna Wai Fun Cheng¹, Hin Biu Chan¹, Lai Sheung Ip², Katy Kit Ying Wan³, Ellen Lok Man Yu⁴, Wa Keung Chiu¹, Pui Hong Chung⁵, Eng Kiong Yeoh⁵

Affiliations

¹ Department of Pediatrics and Adolescent Medicine, United Christian Hospital, Hong Kong, Hong Kong SAR, China.
² Department of Obstetrics and Gynaecology, United Christian Hospital, Hong Kong, Hong Kong SAR, China.
³ Rainbow Lutheran Centre, Hong Kong Lutheran Social Service, Hong Kong, Hong Kong SAR, China.
⁴ Clinical Research Centre, Kowloon West Cluster, Hospital Authority, Hong Kong, Hong Kong SAR, China.
⁵ Centre for Health Systems and Policy Research, The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China.

Abstract

Background/objectives: Maternal illicit drug use is associated with negative physical and developmental outcomes for their born children. We aim to find out the incidence of different developmental problems in a cohort of Chinese children born to drug-abusing mothers, compare the physical health and developmental outcomes of the subjects recruited in the Integrated Program to the Comprehensive Child Development Service (CCDS), and to study the potential factors on their associations.

Methods: A retrospective longitudinal cohort study with frequent clinical assessments of the children's physical and developmental outcomes in a HKSAR's regional hospital from birth until 5 years old. 123 Children in Integrated Program were compared with 214 children in CCDS between 1 January 2008 and 28 February 2019. Cox regression analysis was performed to determine the possible factors associated with the developmental outcomes.

Results: Developmental delay was detected in 129 children (38.9%). CCDS group has significantly higher incidence of cognitive delay (p = < 0.001), language delay (p = < 0.001), motor delay (p = < 0.001), social delay (p = 0.002), and global delay (p = 0.002). On Cox multivariable regression analysis, integrated program (HRadj 0.53, 95% C. I. 0.34-0.84), social support (HRadj 0.45, 95% C.I. 0.25-0.80), and maternal abstinence from drug use up to 2-year post-delivery (HRadj 0.62, 95% C.I. 0.40-0.95) were significant protective factors, while male gender (HRadj 1.73, 95% C.I. 1.18-2.54) was a significant risk factor.

Conclusion: CCDS achieves early engagement of drug-abusing expectant mothers during pregnancy, and an early integrated program with multidisciplinary collaboration was an independent factor in improving the developmental outcomes of these vulnerable children.

Keywords: 0 to 5 years old children; developmental outcome; early integrated program; maternal substance abuse; multidisciplinary collaboration; physical health; social support.