ASSOCIATION OF DRUG-ABUSE AND CHILD-ABUSE

Objective: To show that children born to mothers who used drugs during pregnancy were at a higher risk of subsequent abuse or neglect than w ere children from the general population. Methodology: This is a retro spective-prospective study of abuse experiences of children born at an urban medical center between January 1985 and December 1990 to women who used illicit drugs during pregnancy. Children exposed in-utero to drugs were identified using results of toxicology screens from birth a nd maternal records. Evidence of abuse was obtained from the State Cen tral Registry of Abuse and Neglect. The registry contained information on all reported abuses or neglects, the types, findings, and outcomes of the investigations of reported cases. The outcome measure was whet her the children had been abused or not during the study period. Resul ts: One hundred and fifty-five (30.2%) of the 513 children exposed in- utero to drugs were reported as abused or neglected and 102 (19.9%) ha d substantiated reports giving a rate of 84 abuse and neglect cases pe r 1,000 years of exposure. The yearly substantiated abuse rates varied , the lowest being 30 cases per 1,000 years of exposure in 1986 and th e highest 107 cases per 1,000 in 1987. This rate was two to three time s that of children living in the same geographic area in the south sid e of Chicago. Neglect was reported in 72.6% of cases, with the toddler s being the most vulnerable to abuse and neglect. Natural parents were responsible for maltreatment 88% of the time. On logistic regression analysis, the risk of abuse of children increased 1.56-fold (Confidenc e Interval = 1.25-2.01) that of nonabusing parents among women who had completed high school education or had some college education and 1.8 0-fold among women with previous planned abortion, after controlling f or confounding variables. Other sociodemographic variables of the chil d or mother did not significantly increase the odds of abuse. Conclusi on: Infants exposed in-utero to drugs have a higher than expected risk of subsequent abuse compared to children in the general population.