Hospitalisations and out-of-home placements of children of substance-abusing mothers: a register-based cohort study

Introduction and aims: To study (i) whether the children of substance-abusing mothers are hospitalised because of injury or illness more often than other children; (ii) how often these children are placed out of home; and (iii) how the type of substance used by the mother affects her children.

Design and methods: This was a retrospective population-based cohort study based on Finnish health care and social welfare registers. The participants were all children born in Finland in 2002 (n = 55,369) and their biological mothers (n = 54,519). Mothers with register entries related to substance abuse in the period 1998-2009 were defined as having a substance abuse problem. Children were followed up for their first seven years of life for hospitalisations because of injuries and infectious diseases and out-of-home placements. The associations between hospitalisation and out-of-home care and mothers' type of substance abuse were estimated using logistic regression. The child's gender and the mother's psychiatric disorders and socio-demographic characteristics obtained from the registers were standardised in the final models.

Results: Based on the register data, 2% of mothers had a substance abuse problem. Alcohol problems were more common than drug problems. Children with substance-abusing mothers were more often hospitalised because of injuries and infectious diseases than other children. They had also been placed out of home more often. Mothers' abuse of both alcohol and drugs was a bigger risk for the child than solely alcohol or solely drug abuse.

Discussion and conclusions: The mother's substance abuse has negative outcomes on the child's immediate environment, which affects the health and safety of the child.