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State responses to substance use during pregnancy have included policies designed to increase access to substance use treatment as well as punish such substance use. Prior research has found that punitive policies are associated with increased rates of child maltreatment reporting, but it is unclear if the presence of punitive-promoting policies also moderate the association between access-promoting polices and maltreatment reports. Using data from the National Child Abuse and Neglect Data System and state-level fixed effects models, this study investigates how interactions between access-promoting and punitive prenatal substance use policies are associated with rates of substance use-associated maltreatment reports among infants. In states with punitive policies, access-promoting policies were associated with smaller decreases in these reports than in states without punitive policies. In some cases, access-promoting policies were associated with greater increases in these reports when punitive policies were also present than when only one type of policy was adopted. Interactions between prenatal substance use policies may result in unintended and counterproductive consequences for maternal and child health and the child welfare system. [ABSTRACT FROM AUTHOR]

Stigmatization is a significant healthcare barrier among individuals who utilize substances during pregnancy. Of the 3.6 million U.S. births each year, approximately 10% are affected by perinatal substance use, an estimate which is likely underestimated due to fear of stigma and prosecution. Of those experiencing perinatal substance use, less than 11% receive treatment, while maternal deaths due to overdose during the postpartum period have increased by 81% from 2017 to 2020. Societal perception of non-pregnant individuals experiencing substance use disorders recognizes the biological basis of addiction, whereas for pregnant individuals, societal perception slides into moral failing as the basis of addiction. Many recommendations and guidelines for decreasing substance use stigmatization among non-pregnant and pregnant individuals exist. We focus on the use of mindfulness in recognizing and addressing structural and social stigma within healthcare systems. Mindfulness has been extracted from its roots as an essential element of the Eightfold Path in Buddhism, which largely centers on living ethically to reduce suffering of self and others. By acknowledging the roots of mindfulness, providers can engage mindfully in practices that help identify one's overarching personal values and encourage one to lead healthcare encounters compassion and willingness to support help-seeking community members who are experiencing suffering. A deeper awareness of mindfulness practices within the context of ethical conduct can support healthcare shifts away from criminalization toward more patient- and family-centered approaches. [ABSTRACT FROM AUTHOR]

Introduction: There is a paucity of objectively verified data on substance use among Danish pregnant women. We estimated the prevalence of substance use including alcohol and nicotine among the general population of Danish pregnant women. Material and Methods: In this anonymous, national, cross‐sectional, descriptive study, pregnant women were invited when attending an ultrasound scan between November 2019 and December 2020 at nine Danish hospitals. Women submitted a urine sample and filled out a questionnaire. Urine samples were screened on‐site with a qualitative urine dipstick for 15 substances including alcohol, nicotine, opioids, amphetamines, cannabis, and benzodiazepines. All screen‐positive urine samples underwent secondary quantitative analyses with gold standard, liquid chromatography‐tandem mass spectrometry (LC–MS/MS) analysis. Results were compared to questionnaire information to analyze the validity of self‐reporting and to examine possible cross‐reactions. Results: A total of 1903 of 2154 invited pregnant women participated (88.3%). The prevalence of dipstick‐positive urine samples was 25.0%. 44.0% of these were confirmed positive, resulting in a total confirmed prevalence of 10.8%. The prevalence of nicotine use was 10.1%—and for all other substances, <0.5%. Nicotine use was more prevalent among younger pregnant women, while other substance use appeared evenly distributed over age groups. Self‐reporting of use of nicotine products was high (71.1%), but low for cannabis and alcohol intake (0% and 33.3%, respectively). Prescription medication explained almost all cases of oxycodone, methylphenidate, and benzodiazepine use. Conclusions: Substance use among pregnant women consisted mainly of nicotine. Dipstick screening involved risks of false negatives and false positives. Except for alcohol intake and cannabis use, dipstick analyses did not seem to provide further information than self‐reporting. LC–MS/MS analyses remain gold standard, and future role of dipstick screenings should be discussed. [ABSTRACT FROM AUTHOR]

The article deals with the topic of pregnancy and substance use. It is pointed out that the use of alcohol, tobacco, medications, cannabis, or illegal drugs during pregnancy is often tabooed. The authors emphasize the importance of an appropriate and non-discriminatory approach to pregnant women regarding possible substance use. Screening methods and diagnostic procedures for substance use during pregnancy are presented. In addition, the impact of substance use on childhood and adulthood is discussed. The authors emphasize the need for awareness of alcohol consumption during pregnancy and propose measures to improve the care of individuals with Fetal Alcohol Spectrum Disorders. It is emphasized that guidelines are important but also need to be implemented. Weaknesses in the German healthcare system are pointed out, and the need for more intensive treatment options and guideline-compliant prevention and treatment of harmful tobacco and alcohol use in pregnant women is emphasized. [Extracted from the article]

Prenatal cannabis use and maternal stress have been proposed as risk factors for autism spectrum disorder (ASD). Black mothers and mothers of lower socioeconomic status (SES) may be especially likely to experience high levels of stress. This study examined the impact of prenatal cannabis use and maternal stress (i.e., prenatal distress, racial discrimination, and lower SES) on child ASD-related behaviors in a sample of 172 Black mother-child pairs. We found that prenatal stress was significantly associated with ASD-related behaviors. Prenatal cannabis use did not predict ASD-related behaviors and did not interact with maternal stress to predict ASD-related behaviors. These findings replicate previous work on prenatal stress-ASD associations and add to the limited literature on prenatal cannabis-ASD associations in Black samples. [ABSTRACT FROM AUTHOR]

This document provides a comprehensive list of references and resources related to the diagnosis, treatment, and management of substance use disorders (SUDs) and co-occurring mental health disorders. It includes a wide range of sources, such as articles, reports, guidelines, and textbooks, covering topics such as prevalence, early intervention, treatment approaches, and the impact of substance use on mental health. The document aims to provide valuable information for researchers and individuals seeking to understand and address SUDs and their associated challenges. [Extracted from the article]

Mental health conditions including substance use disorder are the leading cause of pregnancy-related deaths in the U.S. Unfortunately, fears of child protective services' involvement interfere with maternal self-disclosure of substance use in pregnancy. Seeking to identify more mothers with substance use disorder in pregnancy or at delivery, and responsive to changes to the federal Child Abuse Prevention and Treatment Act (CAPTA), Connecticut requires hospital personnel to submit a deidentified notification to CPS for all newborns with prenatal substance exposure. However, it is unknown whether this approach aligns with maternal self-report on substance use. For the present study, we compared population parameters derived from CAPTA notifications submitted between March-December 2019 with parameters derived from self-report data on substance use in pregnancy from mothers who gave birth during the same timeframe. Results revealed that three times as many mothers self-reported any alcohol or drug use in pregnancy compared to the rate measured with CAPTA notifications. Compared to mothers who self-reported drug use in the third trimester, CAPTA notifications were made for statistically similar rates of Black mothers but half the self-reported rate of White and Hispanic mothers. This disparity reflects that CAPTA notifications were made for twice as many Black mothers as White or Hispanic. Although CAPTA notifications are not punitive in nature, this disparity reveals that the public health aims of this policy are not yet achieved. Significance: Accurate and equitable identification of infants with prenatal substance exposure and their mothers, coupled with non-stigmatized, non-punitive intervention is central to any public health response.The current study relies on 2019 data from Connecticut to understand accuracy and equity in identification of these infants by comparing hospital-based notifications to self-report substance use in pregnancy. We found that hospital approaches to detecting prenatal substance exposure identified twice as many Black mothers as White or Hispanic mothers. Compared to self-reported substance use in pregnancy, which detected equivalent rates of substance use across race groups, White and Hispanic mothers' substance use in pregnancy was under-identified in hospital settings. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Child protection system removal within the first 30 days of life in the setting of prenatal substance exposure was associated with short interpregnancy intervals and repeat substance-exposed birth for the mother. Child protection systems often intervene after substance-exposed births but are not designed to address the postpartum needs of the delivering parent. In this retrospective cohort study, we aimed to estimate the association between early child protection system removal and high-risk subsequent birth trajectories among a cohort of mothers with substance-exposed births in California. Of 6,893 births in 2015 with documented prenatal drug and alcohol exposure, 20.4% of mothers experienced child protection system removal within 30 days after birth. First-month child protection system removal was associated with short-interval birth (adjusted hazard ratio [HR] 1.61, 95% CI, 1.09–2.36) and short-interval birth with documentation of substance exposure (adjusted HR 3.17, 95% CI, 1.65–6.08). We found that child separation was associated with an increase, not a reduction, in subsequent substance-exposed births. These findings indicate the need for focused public health and supportive services to address the treatment, health care, family-building, and psychological needs of parents with substance use during pregnancy. [ABSTRACT FROM AUTHOR]

Research has linked pre- and perinatal complications (PPCs) with increased risk for autism spectrum disorder (ASD). However, PPCs are also known risk factors for other mental health disorders. This study explored which PPCs are specific risk factors for ASD, as opposed to other forms of psychopathology, among a large sample of clinically-referred youth. Archival data were used from 1177 youth who were evaluated at a hospital-based autism clinic. Results from logistic regressions indicated that use of tobacco, alcohol, or drugs, or experiencing amniocentesis predicted inclusion in the non-ASD group, while physical difficulties with delivery predicted inclusion in the ASD group. Possible explanations and implications for these findings are discussed. [ABSTRACT FROM AUTHOR]

Mothers who use substances during pregnancy and postpartum may have altered maternal behavior towards their infants, which can have negative consequences on infant social-emotional development. Since maternal substance use has been associated with difficulties in recognizing and responding to infant emotional expressions, investigating mothers' subjective responses to emotional infant stimuli may provide insight into the neural and psychological processes underlying these differences in maternal behavior. In this study, 39 mothers who used substances during the perinatal period and 42 mothers who did not underwent functional magnetic resonance imaging while viewing infant faces and hearing infant cries. Afterwards, they rated the emotional intensity they thought each infant felt ('think'-rating), and how intensely they felt in response to each infant stimulus ('feel'-rating). Mothers who used substances had lower 'feel'-ratings of infant stimuli compared to mothers who did not. Brain regions implicated in affective processing (e.g., insula, inferior frontal gyrus) were less active in response to infant stimuli, and activity in these brain regions statistically predicted maternal substance-use status. Interestingly, 'think'-ratings and activation in brain regions related to cognitive processing (e.g., medial prefrontal cortex) were comparable between the two groups of mothers. Taken together, these results suggest specific neural and psychological processes related to emotional responsivity to infant stimuli may reflect differences in maternal affective processing and may contribute to differences in maternal behavior in mothers who use substances compared to mothers who do not. The findings suggest potential neural targets for increasing maternal emotional responsivity and improving child outcomes. [ABSTRACT FROM AUTHOR]

Background: Alcohol, tobacco and illicit drug use during pregnancy can cause significant harm to women and their developing fetuses. Despite recommendations for abstinence during pregnancy, some women continue to use, making screening for substance use during antenatal clinic attendances an important strategy for reducing risk. This study aims to improve the rates of screening and intervention for substance use among pregnant women, including appropriate referral for those who may be substance-dependent. The protocol outlined here focuses on a multi-stage implementation study. Methods: This study will occur in four phases. Phase 1 will identify a baseline rate of screening and subsequent care at the antenatal clinics of two, South Australian hospital-based maternity services, through a retrospective case note audit. Rates of self-reported substance use identified in the case notes will also be compared against representative data from Adelaide Primary Health Network to establish rates of over or underreporting. Phase 2 will involve an online Training Needs Analysis of midwifery staff working at those services, to assess their knowledge, attitudes, beliefs, and commitment to the care of women who use substances during pregnancy. Phase 3 will involve a training package for all midwifery staff at those services, focused on routine screening for substance use, and how to provide appropriate care. Outcome measures from phase 2 will be reassessed during phase 3 and any changes since training will be evaluated. Phase 4 will then repeat phase 1 to compare the changes in rates of both screening and any associated intervention before and after training. Discussion: From a public health perspective, this project has the potential to make a significant impact on reducing risk of harm from substance use disorders among pregnant women, and contribute to better health outcomes for their children. Trial registration: This trial has been pre-registered under the Open Science Framework. Registration: https://doi.org/10.17605/OSF.IO/73FDZ. A note on terminology: The authors recognize that gender is a diverse, social construct encompassing a person's identity, and therefore not all individuals who give birth will identify as women, or mothers. Sex, on the other hand, often refers to biological attributes which include physical anatomy (internal and external), hormones, and chromosomal type. Given this protocol focuses on issues in which the individual's sex is central, we will refer to women who are pregnant, or women who give birth, in reference to the individual's biological sex. This decision was also taken to avoid unintended harmful consequences from using language that can be dehumanising, disembodying, and ultimately disempowering to women. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this field report is to describe an evaluation of the fidelity with which the comprehensive addiction and recovery act (CARA) policy has been implemented in New Mexico. Description: The CARA program in New Mexico focuses on providing nonpunitive supportive care for pregnant people affected by substance use and on coordinating services for parents, caregivers, and family members of newborns affected by substance exposure. The evaluation used information from program reports, a family follow-up survey, the plan of safe care database, and a data linkage between CARA participant records with Medicaid claims data. Results: Follow-up survey data substantiated the program reports. Both sources showed that families were not engaged consistently in developing or receiving information about plans of safe care. The survey answers also indicated that the time-period immediately after the delivery of a baby is not the best time to communicate the contents of the plan of safe care to families. Additionally, the survey found that respondents believed that medical staff judged them for using substances during pregnancy. The Medicaid data linkage showed that 40.3% of families of infants exposed to substances in-utero did not receive a plan of safe care. Program reports revealed that limited resources existed for implementing CARA. Conclusion: Program funding, limited system capacity, lack of systematic screening for prenatal substance use, regional differences in access to care, and provider biases toward pregnant people using substances affected health-care workers' ability to identify at-risk families and develop plans of safe care. To support CARA implementation, healthcare systems must implement universal prenatal substance use screening, increase the level of anti-bias training pertaining to substance use, increase hospital supports, and improve data management systems. Significance: What is already known on this subject? Stigma towards pregnant people for maternal substance use reduces access to prenatal care due to fear of involvement from child protective services. Punitive approaches to perinatal substance use result in lower healthcare utilization and opportunities to treat substance use disorder. What this study adds? This field report evaluates the implementation of a non-punitive state level policy meant to increase services for pregnant people using substances and reduce reports to child protective services for abuse neglect due to infants exposed to substances prenatally. [ABSTRACT FROM AUTHOR]

Introduction: Postpartum depression (PPD) is a prevalent mental health condition affecting women globally within the first year following childbirth. Substance use during pregnancy has been associated with an increased risk of developing PPD, but the evidence remains inconclusive. This meta-analysis aims to comprehensively assess the effects of different substances on PPD risk, exploring potential modifiers and confounding factors. Objectives: To examine the proportion of PPD among substance users during pregnancy, compared to non-users, and investigate the specific risk associated with different substances (tobacco, alcohol, and non-specified substance use/ multiple substance use). Methods: A systematic literature search was conducted from inception to November 2022 using the Web of Science database (Clarivate Analytics), incorporating Web of Science Core Collection, the BIOSIS Citation Index, the KCI-Korean Journal Database, MEDLINE®, the Russian Science Citation Index, the SciELO Citation Index, and the Cochrane Central Register of Reviews, and Ovid/ PsycINFO databases. Inclusion criteria comprised original studies with pregnant women, using validated depression scales and substance use reporting. Results: Among the 26 included studies, encompassing 514,441 women, the pooled prevalence of PPD among substance users during pregnancy was 29% (95% CI 25– 33). Meta-analyzes revealed an overall odds ratio (OR) of 3.67 (95% CI 2.31–5.85, p < 0.01) indicating a significantly higher risk of PPD among substance users compared to non-users. Subgroup analyzes demonstrated a higher risk for women with nonspecified or multiple substance use (OR 4.67, 95% CI 2.59–8.41; p < 0.01) and tobacco use (OR 4.01, 95% CI 2.23–7.20; p < 0.01). Alcohol use showed a trend toward higher risk that did not reach statistical significance (OR 1.88, 95% CI 1.00–3.55; p = 0.051). Conclusion: This meta-analysis provides evidence of an increased risk of PPD among pregnant substance users, particularly those using multiple substances or tobacco. However, caution is needed in interpreting the association with alcohol use due to its non-significant result. [ABSTRACT FROM AUTHOR]

The article asserts that programs, policies, and systems offering a collaborative approach to service delivery for substance-exposed infants and their families are essential for achieving successful outcomes. Topics discussed include legislation that mandates policies and procedures for collaborative care of infants and their families and opportunities to promote multisystem collaboration to support substance-exposed infants.

An introduction to articles in the issue is presented on topics including critical multidisciplinary needs of children and families, importance of efforts to enhance identification of care of children and families with prenatal substance exposures, and child welfare case managers' perceptions of the relationship between parental substance use and child safety.

Research on opioid use disorder (OUD) in pregnancy has mainly considered women in urban areas receiving treatment, with less known about women in rural areas. We sought to describe demographics and substance use characteristics of pregnant women with OUD and to compare the women based on urbanicity, in a state (Kentucky) with unfavorable economic conditions in many rural counties; we hypothesized that pregnant women in rural areas would have greater adversity, broadly defined, related to substance use. Using data collected from a larger project between 2017 and 2020, we analyzed characteristics of 93 pregnant women (59 rural and 34 urban) with OUD; we examined data in medical, employment, substance use, legal, family history, relationship, and psychiatric health domains, both overall and within rural (population <50,000) and urban (population ≥50,000) strata. Pregnant women with OUD from rural and urban areas were similar on almost all attributes. Among the few significant differences, 30% from urban areas perceived inadequate prenatal care versus 11% from rural areas (p = 0.024); 21% of urban women used amphetamines/methamphetamines in the month before delivery versus 0% of rural women (p < 0.001); and rural women had longer most recent abstinence from substance use than their urban counterparts (medians 7.0 and 2.8 months, p = 0.049). The few significant differences that were discovered favored rural women. These findings, contrary to our hypothesis, suggest that tailoring interventions may require more than focusing on geography. The participants in this study were pregnant women being treated for OUD, and as such there is patient contribution of data. [ABSTRACT FROM AUTHOR]

Opioid use among pregnant and postpartum women and people (PPWP) has significant health repercussions. This study explores how substance-use behaviors may vary by stage in recovery among PPWP with opioid use disorder (OUD). We recruited 29 PPWP with OUD. "High-risk" participants self-identified as "not being engaged in treatment" or "new or early in their recovery" (n = 11); "low-risk" participants self-identified as being "well-established" or "in long-term recovery" (n = 18). Participants were queried regarding sociodemographic, mental health, and drug-misuse factors; urine drug screens were collected at baseline. Univariate group comparisons between high-risk and low-risk PPWP were conducted. High-risk PPWP were more likely to self-identify as non-Hispanic African American and more likely to report current opioid use, other illicit drugs, and tobacco. High-risk PPWP had higher opioid cravings versus low-risk PPWP. High-risk PPWP were more likely to screen positive on urine tests for non-opioid drugs and on concurrent use of both non-opioid drugs and opioids versus low-risk participants. PPWP earlier in recovery are at higher-risk for opioid and other illicit drug misuse but are willing to disclose aspects of their recent use. PPWP early in recovery are an ideal population for interventions that can help facilitate recovery during the perinatal period and beyond. [ABSTRACT FROM AUTHOR]

Background: Substance use during pregnancy has an increasing trend in all socio-economic classes. In addition to the fetal consequences, this problem has many other economic and social harmful effects. This study aimed to determine the prevalence of substance use and its related factors in pregnant women. Methods: This cross-sectional study was performed using a self-administered questionnaire on 587 pregnant women in Kerman, Iran who visited public health centers and private offices to receive prenatal care. Participants were recruited from January to February 2020 using a multistage sampling method. Results: The most prevalent substances used during pregnancy were waterpipe (8.5%), opium (2.6%), and alcohol (1.7%). Substance use in the first-degree relatives strongly correlated with substance use in pregnant women (odds ratio [OR]=7.26). The low educational level of pregnant women’s husbands was also a predictor of substance use in pregnant women (OR=3.15). Conclusion: Since substance use by family members was the strongest correlate of drug use during pregnancy, family-based interventions should be tailored to address early detection of such vulnerable women and to provide appropriate counseling services. [ABSTRACT FROM AUTHOR]

INTRODUCTION Mexico has the highest prevalence of adolescent pregnancies among all the member countries of the Organization for Economic Co-operation and Development (OECD) with a fertility rate of 70.6 births for every 1000 women aged 15-19 years. This study explored the associations between psychoactive substance use and adolescent pregnancy in 3263 adolescents. METHODS This was a cross-sectional study using data from the National Health and Nutrition Survey 2018. We examined adolescent pregnancy among a sample of currently pregnant, ever pregnant and never pregnant teenage girls. The prevalence of psychoactive substance use was estimated at the state level using the 2016 National Survey of Drug, Alcohol, and Tobacco Use. Multilevel logistic models were fitted to evaluate the association between psychoactive substance use and adolescent pregnancy. RESULTS Girls living in states with high prevalence of illegal drug use, non-prescription use of medical drugs, alcohol abuse and daily tobacco use had higher odds of having adolescent pregnancy (OR=1.22, 95% CI: 1.17-1.27; OR=2.00, 95% CI: 1.66-2.39; OR=1.10, 95% CI: 1.03-1.13; and OR=1.05, 95% CI: 1.03-1.18, respectively). Finally, adolescent pregnancy was positively associated with population density (OR=0.85, 95% CI: 0.82-0.88) and number of homicides (OR=1.08, 95% CI: 1.03-1.13). CONCLUSIONS The exposure of adolescents to psychoactive substances may directly contribute to having a pregnancy. Also, these findings highlight the importance of attending school, having high school education and being beneficiaries of the social program CCT-POP in reducing adolescent fertility rates. [ABSTRACT FROM AUTHOR]

Introduction Laws regulating substance use in pregnancy are changing and may have unintended consequences on scientific efforts to address the opioid epidemic. Yet, how these laws affect care and research is poorly understood. Methods We conducted semi-structured qualitative interviews using purposive and snowball sampling of researchers who have engaged pregnant people experiencing substance use. We explored views on laws governing substance use in pregnancy and legal reform possibilities. Interviews were double coded. Data were examined using thematic analysis. Results We interviewed 22 researchers (response rate: 71 per cent) and identified four themes: (i) harms of punitive laws, (ii) negative legal impacts on research, (iii) proposals for legal reform, and (iv) activism over time. Discussion Researchers view laws penalizing substance use during pregnancy as failing to treat addiction as a disease and harming pregnant people and families. Respondents routinely made scientific compromises to protect participants. While some have successfully advocated for legal reform, ongoing advocacy is needed. Conclusion Adverse impacts from criminalizing substance use during pregnancy extend to research on this common and stigmatized problem. Rather than penalizing substance use in pregnancy, laws should approach addiction as a medical issue and support scientific efforts to improve outcomes for affected families. [ABSTRACT FROM AUTHOR]

Background & Aims: rug abuse is a major health challenge all over the world, and the majority of society thinks that drug abuse is mainly a male phenomenon. While drug abuse in women is increasing. Women experience a stressful life with drug abuse and need more support from family and society. If they do not receive the necessary support, they will be stuck in the cycle of addiction and it will be difficult for them to bear failures. Pregnancy with substance abuse poses serious risks to women's mental, psychological, physical and physical health and threatens the mental, social, political and economic health and safety of the society. In this context, midwifery personnel play a role as active people in the health care team and as one of the important sources of information to the community members in increasing social support and bearing more failures. The present study was conducted with the aim of determining the role of social support in coping with the failure of pregnant women with substance abuse who referred to Hazrat Zainab Hospital in Shiraz in 2021. Methods: The current study is a descriptive-cross-sectional study and the statistical population of all pregnant women with substance abuse referring to the clinic, laboratory, IVF unit, ultrasound, emergency department, and inpatient departments who, based on their self-report, declared that they suffered from substance abuse in a 12-month period. The consumption of substances such as cigarettes, opium, opium juice, heroin, crack, glass, hashish, morphine, cocaine, amphetamine, methadone, marijuana, NAS, pan, bong, flower, alprazolam, buponorphine and other substances and in different sections. Hazrat Zainab Hospital was in Shiraz. 200 people were included in the study by continuous sampling. The inclusion criteria included: having Iranian nationality, women aged 18 and above, ability to read and write, being married and with drug abuse according to the individual, mental and physical conditions were suitable.While respecting the privacy and confidentiality of information, demographic questionnaires, VAX social support and Harrington's failure tolerance were completed. Sampling continued from Mehr to Esfand 1400. Data analysis was done with SPSS 22 software with descriptive and analytical statistics tests of frequency, percentage, mean and standard deviation, Pearson correlation coefficient and multiple regressions. Results: In the present study, 200 Iranian pregnant mothers with substance abuse with an average age of 34 years, average age of marriage 21.70 ± 4.51 years, majority of married women, housewives, with unfavorable economic status and no insurance were examined. Women and spouses with primary and secondary education levels had the highest frequency compared to other people. Women with working spouses also had the highest frequency compared to other people. 56% of these women had an unwanted pregnancy and 50 of these women had a history of prison and half of them had a history of prison once. The reason for the conviction of 60% of women was for carrying drugs, 30% for theft and 10% for other reasons. Women with 2 children had the highest frequency. The average social support score of pregnant women with substance abuse was 53.4 ± 2.32, which indicates unfavorable social support. Social support in the support of friends dimension had the highest mean (2.44 ± 0.91) and the support of community members had the lowest mean (2.24 ± 0.64). Social support was more in wives and husbands with middle and higher education levels. The mean failure tolerance score was 136.73±22.5, and failure tolerance was inversely correlated with social support (P=0.012) in the dimension of not tolerating stress, not tolerating discomfort, and not tolerating injustice and dissatisfaction. Conclusion: The social support received by pregnant women with drug abuse is not optimal and these women receive most of their support from friends, family and acquaintances, which provides the basis for more harm to them and makes them more prone to fall into the trap. Addictive Most of these women have not been able to bear failures, so it seems necessary to design and hold life-enhancing programs. Social support in these women was related to the level of education and favorable economic status, which can be helped by promoting education and improving the economic situation by creating simple jobs and educational spaces for these women. [ABSTRACT FROM AUTHOR]

Background: The nexus between pregnancy and substance use disorders is usually studied from the perspective of the fetus, quantitatively examining the risks associated with in utero substance exposure. There is little regard for the mother and her experience. With an awareness of some of the challenges pregnant women with substance use disorders face, the purpose of this research was to explore how pregnancy and substance use disorders are situated within motherhood and to identify opportunities to shift the understanding of women's experiences among health care professionals so more supportive care can be offered. Methods: Narrative inquiry was used for this research. The researcher engaged with three pregnant women who self-identified as having a substance use disorder. Formal and informal conversations, field notes, and a research journal were used to collect data. Narratives were coconstructed between the researcher and each woman. Results: The results are presented as excerpts from each woman's narrative. Narratives extended beyond pregnancy and into a period of conditional motherhood where women were forced to meet state mandated conditions or risk loss of motherhood. Sobriety was fragile and impacted by stressful events such as child apprehension and treatment programs did not meet the needs of mothers. Conclusions: Ongoing, comprehensive services that support pregnant women and are continued into the postpartum period are needed. Peer support models may be an effective means for providing pregnancy specific substance use treatment. Treatment programs must be accessible and meet the distinct needs of women. Extensive breastfeeding support should be considered for women in recovery to promote mother infant attachment. [ABSTRACT FROM AUTHOR]

G.L. is a 32-year-old patient with a history of nicotine use disorder who presents for their first prenatal visit for their third pregnancy. My clinic recently began universal screening for substance use disorders (SUDs) in the prenatal setting, and G.L. has screened positive for nonprescribed opioids. In addition to usual prenatal care, what should I offer G.L. today and in the future? [ABSTRACT FROM AUTHOR]

The article focuses on Suha Godil, a third-year osteopathic medical student, discussing the implications of marijuana use during pregnancy and its lasting impact on maternal and neonatal health. Topics discussed include the social context of marijuana legalization, the physiological effects on fetal development, complications such as cannabinoid hyperemesis syndrome, and the need for comprehensive patient education and intervention strategies in neonatal care.

• Opioid use disorder and pregnancy is becoming less common and is now seen in an ageing patient cohort. • Less women are on opiate substitute therapy. Use of cocaine and cannabis in pregnancy is increasing. • Rates of maternal and perinatal mortality remain high in women with substance use in pregnancy. • These women have high rates of smoking, unemployment, homelessness and psychiatric comorbidities. • Preterm birth, NICU admission and Neonatal Abstinence Syndrome are still high in drug-exposed babies. The aim of this study was to present contemporary trends in opiate use disorder (OUD) and substance use in pregnancy in Ireland, with associated obstetric outcomes, over the last ten years. This retrospective observational cohort study was conducted at an Irish tertiary maternity unit. All women with OUD or substance use in pregnancy delivered under this service between 2010 and 2019 were included. Drug-exposure was self-reported. Data was collected by combining electronic and hand-held patient records. Trends and outcomes were analysed by year of delivery. Approval for the study was granted by the institution's clinical governance committee. Of the 82,669 women delivered, 525 had OUD or substance use in pregnancy (1 in every 160 women booking). 11.6% were homeless, 20.0% were in full-time employment and 91.0% smoked tobacco in pregnancy. 66.3% had a history of psychiatric disorders. Over the ten years, there was a significant reduction in women delivered with OUD or substance use in pregnancy (0.8 % to 0.4 %, RR 0.55, 95 % CI 0.36–0.85), significant reduction in the proportion of women on Opioid-Substitute-Treatment (OST, RR 0.66 95 % CI 0.51–0.87) and an increase in mean maternal age (30.7to32.0 years). Rates of cocaine and cannabis consumption increased (20.6 %, RR 3.8, 95 % CI 1.57–9.44: 24.0 %, RR 3.7, 95 % CI 1.58–8.86 respectively). The maternal mortality rate was 380.9:100,000 births. The perinatal mortality rate was 15.6:1000 births. The preterm birth rate was 17.9 %, with a mean birth weight of 2832 g. The rate of NICU admission was 52.0 % and the mean length of stay was 22.4 days. Amongst the smaller OUD population, the rate of NICU admission for Neonatal Abstinence Syndrome (NAS) and treatment for NAS increased over the study timeframe (36.0 %, RR 2.97, 95 % CI 1.86–4.75: 28.5 %, RR 2.92, 95 % CI 1.70–5.0 respectively). The obstetric population attending an Irish antenatal service with opiate use disorder or substance exposure is reducing in size with older patients, less opioid substitute therapy and increasing cocaine and cannabis use. These women have high rates of maternal and perinatal morbidity and mortality. Specialist antenatal addiction services, coordinated by the drug-liaison midwife, are critical in adapting care to respond to this dynamic and vulnerable patient cohort. [ABSTRACT FROM AUTHOR]

Consumption of addictive substances during pregnancy has been linked with a range of adverse maternal and child health outcomes. The aim of this study was to assess the rates of prevalence of addictive substance use and determine associated risk factors among pregnant women in pastoral community, Afar Region, Northeast Ethiopia. A community-based cross-sectional study design was employed to recruit a total of 484 pregnant women pastoral community in the Afar Region, Ethiopia. A simple random sampling technique was employed to enroll the eligible pregnant women using the health extension workers' family logbook as a sampling frame. Bayesian multivariable logistic regression model was employed using adjusted odds ratio with a 95% Bayesian credible interval. The overall prevalence of substance use during pregnancy was 48.1% [95% CI 39%, 62%]. Of these, 37.6% (95% CI: 33.3-42.1%) were khat chewers, 12.2% (95% CI: 9.5-15.4%) were alcohol drinkers, and 12.6% (95% CI: 9.9-15.9%) were cigarette smokers. Maternal younger age tertiary education level, unplanned pregnancy, husband/partner substance use, and household led by a wife only were positively associated but having four or more ANC visits was negatively associated with maternal prenatal substance use. The prevalence of maternal substance use during pregnancy among the pastoral community in the current study setting was relatively higher. Our finding suggests the urgent need for educational campaigns, screening, and targeted interventions for women of childbearing age in the pastoral community of Ethiopia. Subjects: Health & Society; Health Conditions; Public Health Policy and Practice [ABSTRACT FROM AUTHOR]

Aims. We aimed to investigate child mortality, perinatal morbidities and congenital anomalies born by women with substance misuse during or before pregnancy (DP or BP). Methods. Taiwan Birth Registration from 2004 to 2014 linking Integrated Illicit Drug Databases used to include substance misuse participates. Children born by mothers convicted of substance misuse DP or BP were the substance-exposed cohort. Two substance-unexposed comparison cohorts were established: one comparison cohort selected newborns from the rest of the population on a ratio of 1:1 and exact matched by the child's gender, child's birth year, mother's birth year and child's first use of the health insurance card; another comparison cohort matched newborns from exposed and unexposed mothers by their propensity scores calculated from logistic regression. Results. The exposure group included 1776 DP, 1776 BP and 3552 unexposed individuals in exact-matched cohorts. A fourfold increased risk of deaths in children born by mothers exposed to substance during pregnancy was found compared to unexposed group (hazard ratio [HR] = 4.54, 95% confidence interval (CI): 2.07-9.97]. Further multivariate Cox regression models with adjustments and propensity matching substantially attenuated HRs on mortality in the substance-exposed cohort (aHR = 1.62, 95% CI: 1.10-2.39). Raised risks of perinatal morbidities and congenital anomalies were also found. Conclusions. Increased risks of child mortality, perinatal morbidities or congenital anomalies were found in women with substance use during pregnancy. From estimates before and after adjustments, our results showed that having outpatient visits or medical utilizations during pregnancy were associated with substantially attenuated HRs on mortality in the substance-exposed cohort. Therefore, the excess mortality risk might be partially explained by the lack of relevant antenatal clinical care. Our finding may suggest that the importance of early identification, specific abstinence program and access to appropriate antenatal care might be helpful in reducing newborn mortality. Adequate prevention policies may be formulated. [ABSTRACT FROM AUTHOR]

Substance use during pregnancy is underreported globally and there is limited data on its prevalence and the availability of supportive services. This study determined population perinatal substance use in British Columbia (BC) by region and examined the availability of clinical and community-based programs. Using linked provincial health administrative data, we conducted a population-based retrospective cohort study including all BC residents accessing care for substance use (alcohol, opioids, stimulants, sedatives, and cannabis) within 12 months of first perinatal care record to delivery during 2016–2021. We also conducted an environmental scan to identify all programs offering perinatal care and substance use treatment/support in BC as of December 2022 and described program components by region. The population included 12,439 people with perinatal substance use with 13,814 linked livebirths during the study period. The incidence rate of perinatal substance use was nearly eight times higher in rural/remote Northern BC compared to the metropolitan Vancouver Coastal region (1044.2 vs. 131.3 per 100,000 population, respectively). We identified 29 related services (19 wrap-around programs, 8 supportive housing, and only 2 acute care programs). Residents outside of Metro Vancouver accounted for 60 % (N=1745) of people with perinatal substance use; however, these regions represented only 35 % of BC's specialized acute care and supportive housing beds (N=140). Expanding supports for perinatal substance use - particularly acute care and supportive housing within more rural/remote regions in BC - will be critical to address geographic inequities in access to perinatal care and improve health outcomes for pregnant people who use substances and their infants. • Incidence rates of perinatal substance use were higher in rural/remote areas. • Metro Vancouver comprised a disproportionate majority of specialized programs. • Geographic inequities in specialized acute care and housing programs access. • Needs in expansion and integration of perinatal and substance use care. [ABSTRACT FROM AUTHOR]

Background: Limited research exists on the association between substance use disorders (SUDs) and dimensions of pregnancy intention. This study sought to examine the independent relationships between prepregnancy substance use and SUDs with pregnancy timing and intentions. Materials and Methods: Secondary analysis of data from three prenatal care sites in Connecticut, Massachusetts, and Michigan, 2016–2017. Associations were estimated using modified Poisson regression with robust error variance to calculate adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs), controlling for relevant covariates. Results: The total sample size was 1115 women. Respectively, 61.1% and 15.5% of women used any substance in the 30 days prepregnancy or had any SUD in the past 12 months. After adjustment, any prepregnancy substance use was associated with a reduced likelihood of a well-timed (aPR 0.85; 95% CI: 0.77–0.93) and intended (aPR 0.80; 95% CI: 0.72–0.89) pregnancy; similarly, any SUD was associated with a reduced likelihood of a well-timed (aPR 0.66; 95% CI: 0.55–0.80) and intended (aPR 0.79; 95% CI: 0.67–0.93) pregnancy. Conclusions: Women with prepregnancy substance use or SUD have decreased prevalence of well-timed and intended pregnancies. Greater efforts are needed to address substance use and family planning in routine, well-woman, prenatal, and postpartum care. [ABSTRACT FROM AUTHOR]

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Background: Kratom (Mitragyna speciosa) consumption and associated health effects have raised debates in the United States. Although most people using this herb do not experience adverse health effects associated with kratom use, medical providers should be knowledgeable of emerging substances and concurrent, sequential, or simultaneous use of other drugs which may impact healthcare recommendations and prescribing practices. Methods: The objective of this narrative review was to elucidate selected health effects associated with using kratom—either alone or with other substances. Since scientifically controlled human subjects research on kratom use is still limited, relevant case reports were also described. Results: Cardiovascular, gastrointestinal, neurological, and psychiatric effects associated with kratom use were especially notable, and in-utero exposure accompanied concern regarding a neonate's risk for developing neonatal abstinence syndrome. Our ability to identify and understand the role of this herb in kratom-associated fatalities is complicated since kratom is not routinely screened for in standard forensic toxicology. If a screening is performed, it is usually for the major alkaloid, mitragynine, as a surrogate for kratom use. In addition to lacking a standard practice of screening decedents for kratom alkaloids, the association between mortality and kratom use may be confounded by polysubstance use, adulteration of kratom products, and drug-herb interactions. Conclusions: Increasing medical awareness of this herb is vital to ensuring prompt administration of best-practice medical advice or treatment for people seeking information related to kratom use or for patients experiencing an adverse health effect that may be associated with using or withdrawing from kratom. Knowledge gained from continued surveillance and study of kratom and its associated health effects may assist in guiding clinical decision-making and preventing development of adverse health effects among people using kratom. [ABSTRACT FROM AUTHOR]

State and federal policies regarding substance use in pregnancy, specifically whether a notification to child protective services is required, continue to evolve. To inform practice, policy, and future research, we sought to synthesize and critically evaluate the existing literature regarding the association of prenatal substance exposure with child maltreatment. We conducted a comprehensive electronic search of PubMed, Web of Science, PsycInfo, CHINAL, Social Work Abstracts, Sociological Abstracts, and Social Services Abstracts. We identified 30 studies that examined the association of exposure to any/multiple substances, cocaine, alcohol, opioids, marijuana, and amphetamine/methamphetamine with child maltreatment. Overall, results indicated that substance exposed infants have an increased likelihood of child protective services involvement, maternal self-reported risk of maltreatment behaviors, hospitalizations and clinic visits for suspected maltreatment, and adolescent retrospective self-report of maltreatment compared to unexposed infants. While study results suggest an association of prenatal substance exposure with child maltreatment, there are several methodological considerations that have implications for results and interpretation, including definitions of prenatal substance exposure and maltreatment, study populations used, and potential unmeasured confounding. As each may bias study results, careful interpretation and further research are warranted to appropriately inform programs and policy. [ABSTRACT FROM AUTHOR]

This prospective longitudinal study from birth to late adolescence investigated how early risk predicted subsequent aggression in middle childhood and bullying perpetration, bullying victimization, and violence victimization in adolescence. In addition, the moderating role of protective factors (i.e., maternal sensitivity, positive peers, and school connectedness) on these associations were examined. Caregiver-infant dyads (N = 216; 72% Black/African American) were recruited as part of a longitudinal study on substance exposed youth. Data using multiple methods and informants (observations, interviews, caregiver, and child/youth self-reports) were collected from dyads in early childhood (EC, birth to 48 months), middle childhood (MC, i.e., 84 months), early adolescence (EA, M = 13.26 years, SD =.83) and later adolescence (LA, M = 15.08 years, SD =.83). A developmental cascading path model was tested. There were direct associations between EC maternal harsh parenting and aggression in MC. In turn, MC aggression was associated with higher violence victimization and bullying in EA. Finally, EA violence victimization was then associated with higher levels of bullying as well as victimization from bullying in LA. Consistent with predictions, there was also evidence that protective factors (i.e., maternal sensitivity and positive peers) moderated the impact of predictor variables on aggression and bullying outcomes. Specifically, maternal sensitivity moderated the link between EC and MC aggression, such that those with moderately high levels of maternal sensitivity showed a negative relation between EC and MC aggression, whereas those with low levels of maternal sensitivity showed continuity in aggression. Positive peer influence moderated the link between violence victimization in EA and bullying in LA, such that children high on both violence victimization and positive peers had the highest levels of bullying victimization. [ABSTRACT FROM AUTHOR]

Aims: To estimate the association between punitive policies for women with substance use during pregnancy and odds of neonatal abstinence syndrome (NAS) diagnosis among Medicaid‐insured infants, and to estimate this association controlling for the presence of four other policies related to substance use in pregnancy. Design, Setting and Participants: Analysis of live births in Medicaid claims data from 39 US states in varying years between 2006 and 2014 using weighted generalized linear models with clustered standard errors and state and year fixed‐effects. Measurements NAS rates in states without punitive policies were compared with rates in states with policies before and after policy enactment using logistic regression models adjusted for individual and county‐level factors and including state and year fixed‐effects. We estimated odds of NAS controlling for the presence of a potentially treatment‐deterring policy requiring reporting of suspected prenatal substance use, and three treatment‐supportive policies that create targeted programs for pregnant and postpartum women, prioritize pregnant women's access to substance use disorder treatment programs and prohibit discrimination towards pregnant women in treatment programs. Findings Among 9 714 798 weighted live births (1 896 082 unweighted), 49 670 (0.51%) had an NAS diagnosis. The findings were inconclusive as to whether or not punitive policies were associated with odds of NAS either in the short or long term. Odds of NAS among infants born in states with reporting policies were lower than those born in states without such policies [adjusted odds ratio (aOR) = 0.77, 95% confidence interval (CI) = 0.61–0.98]. Conclusions: In the United States, punitive policies for women with substance use during pregnancy do not appear to be associated with lower odds of neonatal abstinence syndrome (NAS). Reporting policies, which are heterogenous in their components and implementation, appear to be associated with lower odds of NAS when controlling for other relevant policies. [ABSTRACT FROM AUTHOR]

Background: Intimate partner violence (IPV) is one of the most pressing public health conditions among women worldwide, particularly in sub-Saharan Africa. Intimate partner violence in South Africa, along with human immunodeficiency virus (HIV), is an epidemic that is closely linked to trauma and substance use in women. Aim: This study aimed to identify factors associated with IPV among pregnant women, with a specific focus on adverse childhood experiences (ACE), prenatal substance use, and HIV status. Setting: A large public general hospital in the KwaZulu-Natal province. Methods: The sampled study participants included 223 adult postpartum women (18 - 45 years) based on convenience sampling who recently gave birth. Four separate logistic regression models were fitted to examine the role of ACE, perinatal substance abuse and HIV against threat (model 1), physical violence (model 2), sexual violence (model 3) and any IPV (model 4) outcomes (threat and/or physical and/or sexual violence). Results: The prevalence of threat, physical violence, sexual violence and any IPV were 19.7%, 16.6%, 1.8% and 20.2%, respectively. The total ACE scores ranged from 0 to 11 (of 13 possible events) with a mean of 3.28 (standard deviation [s.d.] = 2.76), where 14.4% reported using substances during pregnancy (n = 32) as well as 47.1% (n = 105) of participants living with HIV. The authors found that the presence of family support was protective against IPV physical. Conclusion: It is essential that obstetric services screen and address potential risk factors along the life course pathways from early adversity to adult maternal health that drive IPV, particularly in young women who may lack family support during pregnancy. Contribution: This research gives insight into the dynamics between IPV, HV, ACE and perinatal substance use facing young women in South Africa. [ABSTRACT FROM AUTHOR]

Buprenorphine is emerging as the preferred pharmacologic treatment for opioid use disorder during pregnancy. We examined the relative plasma clearance of buprenorphine (BUP) across pregnancy. Pregnant women with opioid use disorder participating in a prospective, observational study from 2013 to 2016 on stress in pregnancy who were receiving BUP for opioid use disorder were included. Women with an active eating disorder or suicidal ideation were excluded. Research visits occurred at 4–6-week intervals across pregnancy and the early postpartum period and included medication exposure history and blood samples. All assays for BUP serum concentrations at steady state were completed. Relative weight-adjusted clearance (Cl) was calculated using Cl = (daily dose [mg]/ body weight [kg])/serum concentration [ng/ml]. We collected 112 maternal blood samples from 29 women throughout pregnancy and the postpartum period. Serum concentrations for BUP ranged from < 0.2 to 15.8 ng/ml. Eleven women, with greater than three collected samples, increased their daily dose of BUP during pregnancy; however, there were no significant differences in relative clearance of BUP across this same period. This data suggests that women with opioid use disorder receiving BUP did not demonstrate a significant increase in BUP clearance across pregnancy despite increase in dosages during pregnancy. When selecting an appropriate BUP dosage for management of perinatal opioid use disorder, gestational stage appears not to be an important covariate and should be based on an individualized approach. [ABSTRACT FROM AUTHOR]

The incidence of congenital syphilis in the United States is rising. No prenatal care or lack of early detection may be a cause for the rise in this serious yet preventable and treatable disease. Here we review a case, that through physical findings, sparked an index of suspicion to promptly test and treat for congenital syphilis as well as congenital CMV. [ABSTRACT FROM AUTHOR]

• Nealy half of U.S. states have adopted punitive prenatal drug use policies. • Existing literature consistently identifies few health benefits associated with punitive policies. • Evidence for potential harmful effects requires additional research. • Identifying effective policy strategies to support pregnant people with drug use disorder outside of the criminal-legal system is an important priority. Punitive legal responses to prenatal drug use may be associated with unintended adverse health consequences. However, in a rapidly shifting policy climate, current information has not been summarized. We conducted a survey of U.S. state policies that utilize criminal or civil legal system penalties to address prenatal drug use. We then systematically identified empirical studies evaluating these policies and summarized their potential public health impacts. Using existing databases and original statutory research, we surveyed current U.S. state-level prenatal drug use policies authorizing explicit criminalization, involuntary commitment, civil child abuse substantiation, and parental rights termination. Next, we systematically identified quantitative associations between these policies and health outcomes, restricting to U.S.-based peer-reviewed research, published January 2000-December 2022. Results described study characteristics and synthesized the evidence on health-related harms and benefits associated with punitive policies. Validity threats were described narratively. By 2022, two states had adopted policies explicitly authorizing criminal prosecution, and five states allowed pregnancy-specific and drug use-related involuntary civil commitment. Prenatal drug use was grounds for substantiating civil child abuse and terminating parental rights in 22 and five states, respectively. Of the 16 review-identified articles, most evaluated associations between punitive policies generally (k = 12), or civil child abuse policies specifically (k = 2), and multiple outcomes, including drug treatment utilization (k = 6), maltreatment reporting and foster care entry (k = 5), neonatal drug withdrawal syndrome (NDWS, k = 4) and other pregnancy and birth-related outcomes (k = 3). Most included studies reported null associations or suggested increases in adverse outcome following punitive policy adoption. Nearly half of U.S. states have adopted policies that respond to prenatal drug use with legal system penalties. While additional research is needed to clarify whether such approaches engender overt health harms, current evidence indicates that punitive policies are not associated with public health benefits, and therefore constitute ineffective policy. [ABSTRACT FROM AUTHOR]

This prospective longitudinal study examined how maternal prenatal substance use disorder (SUD) and early mother–infant interaction quality are associated with child social cognition (emotion recognition and mentalization) at school age. A sample of 52 poly‐substance‐using mothers receiving early interventions and 50 non‐users, along with their children, was followed from pregnancy to school age. First‐year mother–infant interaction quality was measured with EA scales. At school age, child facial emotion recognition was measured with DANVA and mentalization with LEAS‐C. SUD group children did not differ from comparison children in social cognition, but higher severity of maternal prenatal addiction predicted emotion recognition problems. High early mother–infant interaction quality predicted better emotion recognition and mentalization, and mother–infant interaction quality mediated the effect of prenatal SUD on emotion recognition. The results highlight the need for early treatments targeting both parenting and addiction, as well as long‐term developmental support for these children. Highlights: We examined how mother's prenatal substance use disorder (SUD) and early mother–infant interaction predict child social cognition at school age.Questionnaires, observational and computer tasks were used. Maternal prenatal addiction severity and early parenting problems predicted problematic child social cognition.Early interventions should simultaneously target addiction and parenting. Attention should also be paid to the long‐term developmental support of children. [ABSTRACT FROM AUTHOR]

The article presents the discussion on opioid use in pregnancy escalating in parallel with the opioid epidemic in the general population. Topics include Opioid Use Disorder (OUD) having a profound effect on both mothers and infants; and long term health implications having problems with hearing, vision, learning, and behavior.