How great is the risk of abuse in infants born to drug-using mothers?
This prospective, cohort study reports early child protection and surveillance process markers for children born to self-proclaimed drug-using mothers.


BACKGROUND
A strong association is reported between maternal drug use and child abuse in North American studies. There are no systematic data describing this association for the UK population. Given the heterogeneous nature of drug cultures and associated behaviour it is difficult to generalize from US data to the UK population.


METHODS
The study group consisted of all women referred to a hospital-based antenatal clinic for pregnant drug users. Infants of non-drug users were matched for social class and gestational age. At 18 months the Bristol and surrounding area child protection registers and child health surveillance records were searched. Infants were coded as to whether they were the subject of an enquiry, case conference, registration, registration with subsequent deregistration, or taken into care.


RESULTS
There were 68 infants of drug users and 127 infants of non-drug users. Most (81%) of drug users were heroin and/or methadone users; half were using/had used intravenously. Child health surveillance uptake for both groups is lower than that reported for the Avon population as a whole during the study period, consistent with the relatively deprived populations represented. There is no statistically significant difference between the drug users and non-drug users. The overall risk of child protection proceedings was higher in children of drug users than in children of non-drug users. However, closer inspection of the data shows most of the excess risk is explained by the small group taken into care and the much larger group for whom the concerns were relatively shortlived as shown by their subsequent deregistration during the study period.


CONCLUSIONS
Maternal drug use does not necessarily lead to unacceptable standards of parenting. More UK-based research is needed to inform the risk assessment process for child protection.
Street
K
K
Centre for Child and Adolescent Health, Hampton House, Cotham Hill, Bristol, UK. Karen_street_khan@yahoo.co.uk
Harrington
J
J
Chiang
W
W
Cairns
P
P
Ellis
M
M
D002649:Child Abuse / Q000517:prevention & control / Q000706:statistics & numerical data*; D015331:Cohort Studies; D004739:England; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009034:Mother-Child Relations; D009035:Mothers / Q000523:psychology; D016487:Parenting / Q000523:psychology*; D010865:Pilot Projects; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000523:psychology*