title: Early healthcare utilization and welfare interventions among children of mothers with alcohol and substance abuse: a retrospective cohort study.
abstract: OBJECTIVE
  Early childhood healthcare utilization, mortality and welfare interventions were studied among children of mothers with identified gestational alcohol and/or substance abuse.
  
  
  METHODS
  Register-based retrospective cohort study. The exposed cohort consisted of 638 children born to 524 women followed up antenatally 1992-2001 at special outpatient clinics in the capital area of Finland. Nonexposed children (n = 1914) born to control women were matched for maternal age, parity, number of foetuses, month of birth and delivery hospital of the index child. Postnatal data of both cohorts were collected from national registers until 2007.
  
  
  RESULTS
  The exposed cohort displayed twice the amount of in- and outpatient hospital care episodes compared with nonexposed children. Differences attributable to exposure were found in categories of conditions originating in the perinatal period, mental and behavioural disorders, and nonspecific factors influencing health status and contact with health services. This was reflected in amounts of reimbursements for drugs of the central nervous system, as well as special care allowances and rehabilitation for mental and behavioural disorders. The highest degree of healthcare utilization was observed among exposed children placed in out-of-home care. One-third of these children received outpatient care and one-tenth required inpatient care for a mental and behavioural disorder. No significant differences were found in early mortality.
  
  
  CONCLUSIONS
  The exposed children displayed significant neonatal and early mental and behavioural healthcare utilization, and need for significant psychosocial support during their first decade of life.
authors.affiliation: Children's Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland. taisto.sarkola@helsinki.fi
authors.forename: Taisto
authors.initials: T
authors.lastname: Sarkola
authors.forename: Mika
authors.initials: M
authors.lastname: Gissler
authors.forename: Hanna
authors.initials: H
authors.lastname: Kahila
authors.forename: Ilona
authors.initials: I
authors.lastname: Autti-Rämö
authors.forename: Erja
authors.initials: E
authors.lastname: Halmesmäki
mesh_terms: D016022:Case-Control Studies; D002654:Child Care / Q000706:statistics & numerical data; D002669:Child Welfare / Q000706:statistics & numerical data*; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008137:Longitudinal Studies; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000401:mortality; D012189:Retrospective Studies; D019966:Substance-Related Disorders