Poster #31 - Maternal Prenatal Substance Use and Infant Development: Moderation by Prenatal Treatment and Postnatal Support

• In Event: Poster Session 17

Abstract

Maternal prenatal substance use (PSU) is associated with nonoptimal infant outcomes, including delays across all domains of development (Guille & Aujla, 2019). However, less is known about how social determinants of health, such as mental health, SU, and parenting support, affect this relation. Infants’ prenatal experience affects later developmental outcomes as outlined by the developmental origins of health and disease theory (Gluckman et al., 2005). Because the prenatal environment is embedded within the maternal environment, mother’s overall physical, emotional, and mental well-being influence infant development. Although PSU is associated with less optimal infant outcomes, factors that positively influence the maternal environment, including prenatal treatment for heavy substance use and postnatal support, may buffer the effects of PSU on infant developmental outcomes. We examined the relation between maternal PSU and infant development, with PSU treatment and postnatal support as moderators. We hypothesized that the relation between PSU and infant development would be weaker in mothers who received treatment for PSU versus mothers who did not. Similarly, we hypothesized that the relation between PSU and infant developmental outcomes would be weaker in mothers with high versus low postnatal support.

Participants are mother-infant dyads (N = 272) participating in an ongoing longitudinal study. Mothers were recruited after the first trimester of pregnancy from prenatal clinics, SU treatment centers, and the community and were assessed during pregnancy as well as 1-, 3-, and 6-months post-birth. During pregnancy, mothers reported their SU patterns using a validated calendar-based interview (Sobell & Sobell, 1992) and indicated whether they were currently in treatment for substance use. Using a study-specific survey, mothers reported the amount of postnatal mental health, SU, and/or parenting support they received during the 1- and 3-month visits. At 6-months of child age, infant cognitive, language, and motor development was assessed using the Bayley Scales (BSID; Bayley, 2006).

Given that our sample includes mothers exposed to multiple substances including cocaine, alcohol, tobacco, cannabis, and illicit/prescription opioids, we will create a polysubstance exposure risk score. The score will be computed by creating proportion scores for each substance and creating a composite polysubstance exposure variable with higher scores indicating exposure to greater quantities of substances. We will run two hierarchical regression analyses to assess the effect of prenatal treatment and postnatal social support (count variable), respectively on the relation between maternal PSU and infant developmental outcomes. For each regression we will enter maternal education in the first step, followed by PSU and prenatal treatment and postnatal support, respectively, in the second step. In the final step, we will enter the interaction terms of PSU and prenatal treatment and postnatal support, respectively. We expect to find main effects of PSU, prenatal treatment and postnatal support on child developmental outcomes. We also expect to find a significant interaction in each model such that maternal PSU has less of an effect on infant development for mothers in substance use treatment during pregnancy and for mothers who have more support postnatally. Significant interaction terms will be probed using simple slopes analyses.

Authors

• Eman Abdallah, University of North Carolina at Chapel Hill
  Presenting Author

• Madison Rachel Kelm, Pennsylvania State University, University Park

• Rina Das Eiden, The Pennsylvania State Univeristy

• Karen Grewen