Abstract
To determine the characteristics and childbearing histories of women whose infants entered foster care in Los Angeles County, we examined the cases of 1,155 drug-using women whose infants were removed from them at birth and 236 non-drug-using women whose infants were also removed at birth by court order (July 1989 through March 1991). All of the women were indigent, and less than half had graduated from high school. The drug-using women frequently had criminal records, and more than a quarter were homeless. Many comparison women had mental health problems, and some (16.7%) were teenagers under court custody. Overall, 80% of all the children born to both groups of women were under court jurisdiction. Data obtained after study infants' births on 926 drug-using women observed for 18 months revealed that 22% had borne another infant who was placed in foster care; half of these infants had a positive drug immunoassay. Of the 185 non-drug-using women with 18-month follow-ups, 7.6% had borne another child who was in foster care. The magnitude of the repeated childbearing recorded among both groups of women in this study shows that preventive programs including family planning, mental health services, and drug prevention or rehabilitation programs have not reached this population.
Full text
PDF





Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Berenson A. B., Stiglich N. J., Wilkinson G. S., Anderson G. D. Drug abuse and other risk factors for physical abuse in pregnancy among white non-Hispanic, black, and Hispanic women. Am J Obstet Gynecol. 1991 Jun;164(6 Pt 1):1491–1499. doi: 10.1016/0002-9378(91)91428-y. [DOI] [PubMed] [Google Scholar]
- Bingol N., Fuchs M., Diaz V., Stone R. K., Gromisch D. S. Teratogenicity of cocaine in humans. J Pediatr. 1987 Jan;110(1):93–96. doi: 10.1016/s0022-3476(87)80297-4. [DOI] [PubMed] [Google Scholar]
- Brenneman G., Vanderwagen C., Porvaznik J. Infant mortality among American Indian and Alaska Native populations: successes and challenges. Child Today. 1990 Mar-Apr;19(2):21–24. [PubMed] [Google Scholar]
- Bry B. H. Substance abuse in women. Etiology and prevention. Issues Ment Health Nurs. 1983;5(1-4):253–272. doi: 10.3109/01612848309009443. [DOI] [PubMed] [Google Scholar]
- Burkett G., Yasin S., Palow D. Perinatal implications of cocaine exposure. J Reprod Med. 1990 Jan;35(1):35–42. [PubMed] [Google Scholar]
- Calhoun B. C., Watson P. T. The cost of maternal cocaine abuse: I. Perinatal cost. Obstet Gynecol. 1991 Nov;78(5 Pt 1):731–734. [PubMed] [Google Scholar]
- Chang G., Carroll K. M., Behr H. M., Kosten T. R. Improving treatment outcome in pregnant opiate-dependent women. J Subst Abuse Treat. 1992 Fall;9(4):327–330. doi: 10.1016/0740-5472(92)90026-k. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Chasnoff I. J., Burns K. A., Burns W. J. Cocaine use in pregnancy: perinatal morbidity and mortality. Neurotoxicol Teratol. 1987 Jul-Aug;9(4):291–293. doi: 10.1016/0892-0362(87)90017-1. [DOI] [PubMed] [Google Scholar]
- Chasnoff I. J., Hunt C. E., Kletter R., Kaplan D. Prenatal cocaine exposure is associated with respiratory pattern abnormalities. Am J Dis Child. 1989 May;143(5):583–587. doi: 10.1001/archpedi.1989.02150170085028. [DOI] [PubMed] [Google Scholar]
- Chiu T. T., Vaughn A. J., Carzoli R. P. Hospital costs for cocaine-exposed infants. J Fla Med Assoc. 1990 Oct;77(10):897–900. [PubMed] [Google Scholar]
- Chouteau M., Namerow P. B., Leppert P. The effect of cocaine abuse on birth weight and gestational age. Obstet Gynecol. 1988 Sep;72(3 Pt 1):351–354. [PubMed] [Google Scholar]
- Culver K. W., Ammann A. J., Partridge J. C., Wong D. F., Wara D. W., Cowan M. J. Lymphocyte abnormalities in infants born to drug-abusing mothers. J Pediatr. 1987 Aug;111(2):230–235. doi: 10.1016/s0022-3476(87)80073-2. [DOI] [PubMed] [Google Scholar]
- Dattel B. J. Substance abuse in pregnancy. Semin Perinatol. 1990 Apr;14(2):179–187. [PubMed] [Google Scholar]
- Dubowitz H., Feigelman S., Zuravin S., Tepper V., Davidson N., Lichenstein R. The physical health of children in kinship care. Am J Dis Child. 1992 May;146(5):603–610. doi: 10.1001/archpedi.1992.02160170083021. [DOI] [PubMed] [Google Scholar]
- Dubowitz H., Zuravin S., Starr R. H., Jr, Feigelman S., Harrington D. Behavior problems of children in kinship care. J Dev Behav Pediatr. 1993 Dec;14(6):386–393. [PubMed] [Google Scholar]
- Evans A. T., Gillogley K. Drug use in pregnancy: obstetric perspectives. Clin Perinatol. 1991 Mar;18(1):23–32. [PubMed] [Google Scholar]
- Frank D. A., Zuckerman B. S., Amaro H., Aboagye K., Bauchner H., Cabral H., Fried L., Hingson R., Kayne H., Levenson S. M. Cocaine use during pregnancy: prevalence and correlates. Pediatrics. 1988 Dec;82(6):888–895. [PubMed] [Google Scholar]
- Gittler J., McPherson M. Prenatal substance abuse. Child Today. 1990 Jul-Aug;19(4):3–7. [PubMed] [Google Scholar]
- Graham K., Koren G. Characteristics of pregnant women exposed to cocaine in Toronto between 1985 and 1990. CMAJ. 1991 Mar 1;144(5):563–568. [PMC free article] [PubMed] [Google Scholar]
- Green M., Silverman I., Suffet F., Taleporos E., Turkel W. V. Outcomes of pregnancy for addicts receiving comprehensive care. Am J Drug Alcohol Abuse. 1979;6(4):413–429. doi: 10.3109/00952997909007053. [DOI] [PubMed] [Google Scholar]
- Guinan M. E., Hardy A. Epidemiology of AIDS in women in the United States. 1981 through 1986. JAMA. 1987 Apr 17;257(15):2039–2042. [PubMed] [Google Scholar]
- Halfon N., Berkowitz G., Klee L. Mental health service utilization by children in foster care in California. Pediatrics. 1992 Jun;89(6 Pt 2):1238–1244. [PubMed] [Google Scholar]
- Hoff R., Berardi V. P., Weiblen B. J., Mahoney-Trout L., Mitchell M. L., Grady G. F. Seroprevalence of human immunodeficiency virus among childbearing women. Estimation by testing samples of blood from newborns. N Engl J Med. 1988 Mar 3;318(9):525–530. doi: 10.1056/NEJM198803033180901. [DOI] [PubMed] [Google Scholar]
- Hume R. F., Jr, O'Donnell K. J., Stanger C. L., Killam A. P., Gingras J. L. In utero cocaine exposure: observations of fetal behavioral state may predict neonatal outcome. Am J Obstet Gynecol. 1989 Sep;161(3):685–690. doi: 10.1016/0002-9378(89)90380-3. [DOI] [PubMed] [Google Scholar]
- Kaye K., Elkind L., Goldberg D., Tytun A. Birth outcomes for infants of drug abusing mothers. N Y State J Med. 1989 May;89(5):256–261. [PubMed] [Google Scholar]
- Keith L. G., MacGregor S., Friedell S., Rosner M., Chasnoff I. J., Sciarra J. J. Substance abuse in pregnant women: recent experience at the Perinatal Center for Chemical Dependence of Northwestern Memorial Hospital. Obstet Gynecol. 1989 May;73(5 Pt 1):715–720. [PubMed] [Google Scholar]
- Klee L., Halfon N. Mental health care for foster children in California. Child Abuse Negl. 1987;11(1):63–74. doi: 10.1016/0145-2134(87)90034-2. [DOI] [PubMed] [Google Scholar]
- Little B. B., Snell L. M., Gilstrap L. D., 3rd, Johnston W. L. Patterns of multiple substance abuse during pregnancy: implications for mother and fetus. South Med J. 1990 May;83(5):507-9, 518. doi: 10.1097/00007611-199005000-00008. [DOI] [PubMed] [Google Scholar]
- MacGregor S. N., Keith L. G., Bachicha J. A., Chasnoff I. J. Cocaine abuse during pregnancy: correlation between prenatal care and perinatal outcome. Obstet Gynecol. 1989 Dec;74(6):882–885. [PubMed] [Google Scholar]
- Martin M. A. The homeless mentally ill and community-based care: changing a mindset. Community Ment Health J. 1990 Oct;26(5):435–447. doi: 10.1007/BF00761070. [DOI] [PubMed] [Google Scholar]
- Melnikow J., Alemagno S. A., Rottman C., Zyzanski S. J. Characteristics of inner-city women giving birth with little or no prenatal care: a case-control study. J Fam Pract. 1991 Mar;32(3):283–288. [PubMed] [Google Scholar]
- Neuspiel D. R., Zingman T. M., Templeton V. H., DiStabile P., Drucker E. Custody of cocaine-exposed newborns: determinants of discharge decisions. Am J Public Health. 1993 Dec;83(12):1726–1729. doi: 10.2105/ajph.83.12.1726. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Oro A. S., Dixon S. D. Perinatal cocaine and methamphetamine exposure: maternal and neonatal correlates. J Pediatr. 1987 Oct;111(4):571–578. doi: 10.1016/s0022-3476(87)80125-7. [DOI] [PubMed] [Google Scholar]
- Phibbs C. S., Bateman D. A., Schwartz R. M. The neonatal costs of maternal cocaine use. JAMA. 1991 Sep 18;266(11):1521–1526. [PubMed] [Google Scholar]
- Racine A., Joyce T., Anderson R. The association between prenatal care and birth weight among women exposed to cocaine in New York City. JAMA. 1993 Oct 6;270(13):1581–1586. [PubMed] [Google Scholar]
- Regier D. A., Farmer M. E., Rae D. S., Locke B. Z., Keith S. J., Judd L. L., Goodwin F. K. Comorbidity of mental disorders with alcohol and other drug abuse. Results from the Epidemiologic Catchment Area (ECA) Study. JAMA. 1990 Nov 21;264(19):2511–2518. [PubMed] [Google Scholar]
- Scott G. B., Fischl M. A., Klimas N., Fletcher M. A., Dickinson G. M., Levine R. S., Parks W. P. Mothers of infants with the acquired immunodeficiency syndrome. Evidence for both symptomatic and asymptomatic carriers. JAMA. 1985 Jan 18;253(3):363–366. [PubMed] [Google Scholar]
- Slutsker L., Smith R., Higginson G., Fleming D. Recognizing illicit drug use by pregnant women: reports from Oregon birth attendants. Am J Public Health. 1993 Jan;83(1):61–64. doi: 10.2105/ajph.83.1.61. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Spear L. P., Kirstein C. L., Frambes N. A. Cocaine effects on the developing central nervous system: behavioral, psychopharmacological, and neurochemical studies. Ann N Y Acad Sci. 1989;562:290–307. doi: 10.1111/j.1749-6632.1989.tb21027.x. [DOI] [PubMed] [Google Scholar]
- Stehno S. M. The elusive continuum of child welfare services: implications for minority children and youths. Child Welfare. 1990 Nov-Dec;69(6):551–562. [PubMed] [Google Scholar]
- Teske M. P., Trese M. T. Retinopathy of prematurity-like fundus and persistent hyperplastic primary vitreous associated with maternal cocaine use. Am J Ophthalmol. 1987 May 15;103(5):719–720. doi: 10.1016/s0002-9394(14)74343-0. [DOI] [PubMed] [Google Scholar]
- Zuckerman B., Frank D. A., Hingson R., Amaro H., Levenson S. M., Kayne H., Parker S., Vinci R., Aboagye K., Fried L. E. Effects of maternal marijuana and cocaine use on fetal growth. N Engl J Med. 1989 Mar 23;320(12):762–768. doi: 10.1056/NEJM198903233201203. [DOI] [PubMed] [Google Scholar]
