title: [Developmental outcome of 5-year-old children born to opiate-dependent mothers: effects of a multidisciplinary intervention during pregnancy].
abstract: BACKGROUND
  Studies on infant outcomes of opiate-dependent pregnant women find a high rate of premature mother-child separation and to a lesser extent developmental delay. The specific role of in utero heroin exposure in the determination of the developmental outcome seems to be less important than the home environment.
  
  
  OBJECTIVE
  Describe the health and development of 5-year-old children whose drug-addict mothers allowed an early multidisciplinary intervention (medical and psychological) in the maternity hospital and neonatology.
  
  
  METHODS
  Thirty-seven children (62% of the initial cohort) were seen in consultation with their parents. Growth and development was compared with a control group of 374 children of the same age. Comparisons were made between the children's and parents' state (social, medical, drug addiction, etc.) upon discharge from the maternity hospital and 5 years later. A study was conducted on those lost to follow-up.
  
  
  RESULTS
  The rate of placement in 5 years was very low (13%). Seven children showed a developmental delay, 21 no disorder, and nine some problems. Anxiety (37%) and overweight (48%) were the only disorders differentiating them from the control group. Compliance with the care provided in the maternity hospital was the only item significantly related to the development of the 5-year-old children (P=0.05).
  
  
  CONCLUSIONS
  The hypothesis of an attachment disorder in those with the greatest need is raised. The likely relations between the quality of the care in the maternity hospital, mother-child relations, and the attrition of the cohort are also discussed.
  
  
  CONCLUSIONS
  Management of the symptoms as well as social and psychological care during pregnancy and neonatal hospitalization for opiate-dependent pregnant women facilitates a long-lasting relation with childhood professionals, avoids court-ordered placements, and reduces the appearance of developmental disorders in these children.
authors.affiliation: Service de pédopsychiatrie, unité petite enfance, clinique Peyre-Plantade, hôpital La-Colombiére, 34090 Montpellier, France. roynenuphare@orange.fr
authors.forename: J
authors.initials: J
authors.lastname: Roy
authors.forename: R-M
authors.initials: RM
authors.lastname: Toubin
authors.forename: E
authors.initials: E
authors.lastname: Mazurier
authors.forename: C
authors.initials: C
authors.lastname: Chanal
authors.forename: M
authors.initials: M
authors.lastname: Misraoui
authors.forename: C
authors.initials: C
authors.lastname: Brulet
authors.forename: F
authors.initials: F
authors.lastname: Molenat
mesh_terms: D002648:Child; D002657:Child Development; D002669:Child Welfare; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D009034:Mother-Child Relations; D009293:Opioid-Related Disorders; D010348:Patient Care Team; D011247:Pregnancy; D011248:Pregnancy Complications; D011297:Prenatal Exposure Delayed Effects