P. Nair et al., RISK-FACTORS FOR DISRUPTION IN PRIMARY CAREGIVING AMONG INFANTS OF SUBSTANCE-ABUSING WOMEN, Child abuse & neglect, 21(11), 1997, pp. 1039-1051
Objective: To identify perinatal factors that are predictive of disrup
tion in primary caregiving among infants of substance abusing women. M
ethod: A randomized longitudinal cohort study. One hundred and fifty t
wo mother/infant dyads were assessed for evidence of disruption of pri
mary caregiving or neglect during the first 18 months of life, defined
by mother's inability to provide care. Data analyzed included neonata
l characteristics, urine toxicology at delivery, maternal history of d
rug use, maternal depression, social support, and social and health hi
story. Results: Sixty-six infants (43.4%) had disruption in their prim
ary care during the first 18 months of their life, 86 infants (56.6%)
remained in the care of their mothers. Women who were younger, were he
roin users, had two or more children, had other children in foster car
e, and reported depressive symptoms were least likely to provide ongoi
ng primary care for their infant. Conclusions: Although all infants bo
rn to substance abusing women are at a high risk for disruption in the
continuity of their primary caregiving, maternal demographic and psyc
hosocial factors present at delivery can predict which infants are lik
ely to experience an early disruption in their primary caregiving. Ide
ntifying these families can enable health care providers to monitor th
em more closely and, when appropriate, encourage support from the exte
nded family. (C) 1997 Elsevier Science Ltd.