Evidence map›Paper›PMID 40118246›Full record

ArticleThe Journal of pediatrics2025

Prenatal Substance Exposure and Multilevel Predictors of Child Protection System Reporting.

Julia Reddy, Carolyn T Halpern, Davida M Schiff, Hendree Jones, Anna Austin, Laura Faherty, Rebecca Rebbe, Anissa Vines, Emily Putnam-Hornstein

Abstract read
In one paragraph

Article in The Journal of pediatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Julia ReddyDepartment of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC. Electronic address: jreddy@email.unc.edu.
Carolyn T HalpernDepartment of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC.
Davida M SchiffDivision of General Academic Pediatrics and Newborn Medicine, Mass General for Children, Boston, MA.
Hendree JonesDepartment of Obstetrics & Gynecology, University of North Carolina Chapel Hill, Chapel Hill, NC.
Anna AustinDepartment of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC.
Laura FahertyDepartment of Behavioral and Policy Sciences, RAND, Boston, MA.
Rebecca RebbeUniversity of North Carolina Chapel Hill School of Social Work, Chapel Hill, NC.
Anissa VinesDepartment of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC.
Emily Putnam-HornsteinUniversity of North Carolina Chapel Hill School of Social Work, Chapel Hill, NC.

Funding

Implementation and Outcomes of Child Protection System Reporting Policies Regarding Infants Born with Prenatal Substance ExposureF31DA057756 · NIDA · UNIV OF NORTH CAROLINA CHAPEL HILL · PI REDDY, JULIA · 2023 to 2024
$81k
NCIPC CDC HHS K01 CE003548NIDA NIH HHS F31 DA057756
6 · The paper itself

Abstract

objectiveTo describe child protection system (CPS) reports after delivery and examine associations between individual- and hospital-level predictors and CPS reporting in a cohort of infants with prenatal substance exposure. STUDY

designThis state-level, retrospective cohort study used administrative data to analyze births to Black, White, and US-born Hispanic mothers with documented prenatal substance exposure. We used a random intercept mixed-model with individual- and hospital-level predictors to capture any association between birth hospital and CPS reporting. Interaction terms allowed for different effects dependent on characteristics of the delivering parent and the dominant demographics of the hospital setting.

resultsAmong 260 525 births during 2018 in California, 2.6% had documented substance exposure, with observed racial differences in substance use and type. Nearly 4% of births to Black mothers had documented cannabis exposure compared with roughly 1% among White and Hispanic mothers. The delivery hospital explained 24% of variance in CPS reporting. Hierarchical models revealed race and insurance-type differences in the likelihood a CPS report followed a substance exposed birth. Namely, publicly-insured births in hospitals where majority births were covered by private insurance had nearly twice the probability of being reported compared with those with private insurance.

conclusionsWe found variation in CPS reporting of births with diagnosed substance exposure at the hospital level, and interactions between hospital- and individual-level characteristics in their association with the likelihood of CPS reporting. Associations offer insight into potential areas of bias and inconsistency in policy implementation that might be diminished through improved decision-making tools and provider training.

Indexed as

Child Protective ServicesPrenatal Exposure Delayed EffectsSubstance-Related DisordersAdultCaliforniaFemaleHumansInfantInfant, NewbornMalePregnancyRetrospective Studiesdrug/alcoholhierarchical modelinghospitalpolicyracestatistical interaction

Identifiers

PMID40118246
PMCPMC13234835

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.