학술논문

Educational Disabilities Among Children Born With Neonatal Abstinence Syndrome.
Document Type
Article
Source
Pediatrics. Sep2018, Vol. 142 Issue 3, p1-8. 8p.
Subject
*PSYCHOTHERAPY patients
*AGE distribution
*BIRTH certificates
*BIRTH weight
*FUNCTIONAL assessment
*ETHNIC groups
*GESTATIONAL age
*HEALTH education
*HOSPITAL admission & discharge
*MEDICAID
*MEDICAL needs assessment
*PEOPLE with intellectual disabilities
*MULTIVARIATE analysis
*NEONATAL intensive care
*PATIENTS
*POPULATION geography
*RACE
*SEX distribution
*SMOKING
*SPECIAL education
*MULTIPLE regression analysis
*RESIDENTIAL patterns
*EDUCATIONAL attainment
*NEONATAL intensive care units
*EDUCATIONAL outcomes
*NEONATAL abstinence syndrome
*CHILDREN
*EDUCATION
Language
ISSN
0031-4005
Abstract
BACKGROUND: Neonatal abstinence syndrome (NAS) is a postnatal drug withdrawal syndrome that can occur after intrauterine opioid exposure. Adverse neurobehavioral outcomes have been documented in infants with NAS; however, educational outcomes have not been thoroughly examined. We analyzed Tennessee data to understand the need for special educational services among infants who are born with NAS. METHODS: By using Tennessee Medicaid and birth certificate data, infants who were born in Tennessee between 2008 and 2011 with a history of NAS were matched (1:3) to infants who were born during the same period without a history of NAS. Groups were matched on the basis of sex, race and/or ethnicity, age, birth region of residence, and Medicaid enrollment status. Data were linked to Tennessee Department of Education special education data during early childhood (3--8 years of age). Conditional multivariable logistic regression was used to assess associations between NAS and selected special education outcomes. RESULTS: A total of 1815 children with a history of NAS and 5441 children without NAS were assessed. Children with NAS were significantly more likely to be referred for a disability evaluation (351 of 1815 [19.3%] vs 745 of 5441 [13.7%]; P < .0001), to meet criteria for a disability (284 of 1815 [15.6%] vs 634 of 5441 [11.7%]; P < .0001), and to require classroom therapies or services (278 of 1815 [15.3%] vs 620 of 5441 [11.4%]; P < .0001). These findings were sustained in a multivariable analysis, with multiple models controlling for maternal tobacco use, maternal education status, birth weight, gestational age, and/or NICU admission. CONCLUSIONS: Results of this novel analysis linking health and education data revealed that children with a history of NAS were significantly more likely to have a subsequent educational disability. [ABSTRACT FROM AUTHOR]