Behavioral development in children with prenatal substance exposure and neonatal abstinence syndrome: Associated factors and implications

Problem Prenatal substance exposure and neonatal abstinence syndrome (NAS) are risk factors for adverse behavioral outcomes in children at 24 months of age. Methods The purpose of this study was to examine factors associated with abnormal behavioral development in children with prenatal substance exposure or NAS through 10 years of age. A retrospective, nonexperimental, longitudinal design to examine the effects of prenatal substance exposure and NAS on behavioral development at 1, 5, and 10 years of age, while controlling for intrapersonal, interpersonal, community, organizational, and public policy characteristics. A hierarchical multivariate logistic regression model was used to evaluate the influence of substance exposure and NAS on behavioral outcomes. Findings Abnormal behavioral development was predicted at 10 years of age with polysubstance exposure to three substances (odds ratio [OR] = 2.711, p < 0.01) and NAS (OR = 2.077, p < .001). Conclusion Psychiatric nursing care for children with prenatal substance exposure and NAS should include implementation of early and continued behavioral evaluation and childhood trauma and adversity surveillance in children through middle childhood.