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Cited by 44Prenatal Substance Exposure EffectsInfant Development and Preterm CareChild Welfare and Adoption

Early Intervention Referral and Enrollment Among Infants with Neonatal Abstinence Syndrome

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Peacock-Chambers, Elizabeth, Leyenaar, JoAnna K., Foss, Sheila, Feinberg, Emily, Wilson, Donna, Friedmann, Peter D., Visintainer, Paul, Singh, Rachana·2019·Journal of Developmental & Behavioral Pediatrics
DOI 10.1097/dbp.0000000000000679PMC PMC7114910
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Abstract

Objective: To identify factors associated with referral and enrollment in early intervention (EI) for infants with neonatal abstinence syndrome (NAS). Methods: We conducted a retrospective cohort study of 256 infants born with NAS (2006–2013) at a tertiary care hospital in (Springfield), Massachusetts, linking maternal-infant birth hospitalization records with Department of Public Health EI records. We calculated the percent of infants retained at each step in the EI enrollment process over the first 3 years of life. We conducted separate multivariable logistic regression analyses to identify factors associated with EI referral and enrollment. Results: Among mothers, 82% received medication-assisted treatment at delivery, 36% endorsed illicit drug use during pregnancy, and 76% retained custody of their child at discharge. Among infants, 77% were referred to EI and 48% were enrolled in services. Of infants discharged to biological parents, 81% were referred to EI versus 66% of infants discharged to foster care (p ≤ 0.05); this difference persisted in multivariable analysis [adjusted odds ratio, 2.30; 95% confidence interval (CI), 1.09–4.86]. Infants in the highest tertile for length of stay had 2.70 times the odds of EI enrollment (95% CI, 1.37–5.31). Conclusion: Fewer than half of the eligible infants with NAS were enrolled in EI services. Discharge to a biological parent and longer hospital stay had the strongest associations with EI referral and enrollment, respectively. Efforts to improve EI referral rates during the birth hospitalization, particularly among infants discharged into foster care, and close follow-up for infants with shorter hospital stays would enhance the developmental supports for this vulnerable population.

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  • Lack of self-efficacy as well as potential bias or stigma associated with parents in recovery on the part of EI providers may contribute to low rates of trust, enrollment, and engagement in home visiting programs among mothers with SUDs.

    “This lack of self-efficacy as well as potential bias or stigma associated with parents in recovery on the part of EI providers may contribute to low rates of trust, enrollment, and engagement in home visiting programs among mothers with SUDs (Peacock-Chambers et al., 2019)”

    From Home‐based family recovery supports: Feasibility, acceptability, and adoption of training home visitors in “Mothering from the Inside Out” (2025) · cites this paper as Peacock-Chambers et al., 2019

    The Discussion (page unavailable) reports attrition during EI enrollment and suggests that trust built between families and hospital providers during longer stays may encourage follow-through with referrals. The Limitations (page unavailable) also identify unmeasured personal beliefs as a possible influence on engagement. Neither passage addresses mothers’ self-efficacy, bias or stigma among EI providers, or enrollment and engagement in home visiting programs specifically. (LLM, conf=0.85)

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  • Less than half of all eligible newborns with exposure to substances are enrolled in EI by a caregiver.

    “We have previously reported that less than half of all eligible newborns with exposure to substances are enrolled in EI by a caregiver (Peacock-Chambers et al., 2019).”

    From Home‐based family recovery supports: Feasibility, acceptability, and adoption of training home visitors in “Mothering from the Inside Out” (2025) · cites this paper as Peacock-Chambers et al., 2019

    The Abstract Conclusion states that fewer than half of eligible infants with neonatal abstinence syndrome (NAS) were enrolled in EI, and the Methods describe enrollment as a process families complete. The claim extends that finding from the study’s NAS cohort at one Massachusetts hospital to all eligible substance-exposed newborns, which the paper does not establish. (LLM, conf=0.88)

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Authors
Peacock-Chambers, E., Leyenaar, J. K., Foss, S., Feinberg, E., Wilson, D., Friedmann, P. D., Visintainer, P., & Singh, R.
Affiliations
  • Department of Pediatrics, University of Massachusetts Medical School-Baystate, Springfield, MA;
  • Dartmouth College (US)
  • Baystate Medical Center (US)
  • Boston University (US)
  • Department of Medicine, Office of Research, UMMS-Baystate, Springfield, MA.
Corresponding author
  • Foss, Sheila
  • Singh, Rachana
ORCID
Venue
Journal of Developmental & Behavioral Pediatrics
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2019-07
Volume
40
Issue
6
Pages
441-450
ISSN
0196-206X (ISSN-L)
DOI
10.1097/dbp.0000000000000679
PMC
PMC7114910
OpenAlex
W2946660103
Cited by
44
References
4
Citations by year
2026: 4 · 2025: 6 · 2024: 10 · 2023: 5 · 2022: 2 · 2021: 8 · 2020: 5 · 2019: 4
FWCI
4.94
Type
journal article
Language
en
Open access
Locations
  • Journal of Developmental & Behavioral Pediatrics (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (KL2TR002545)
  • National Center for Advancing Translational Sciences
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Development and Preterm Care
  • Social Sciences › Safety Research › Child Welfare and Adoption
Keywords
neonatal abstinence syndrome, early intervention, infants, foster care, length of hospital stay, prenatal drug exposure, birth hospitalization
MeSH terms
Adult, Female, Hospitalization, Humans, Infant, Newborn, Male, Massachusetts, Mothers, Opioid-Related Disorders, Neonatal Abstinence Syndrome, Pregnancy, Pregnancy Complications, Referral and Consultation, Retrospective Studies, Young Adult, Early Medical Intervention

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