TOP 14 - Prenatal Substance Exposure: Demographic and Developmental Data Trends in Pediatric Outpatient Clinics at an Urban Academic Medical Center

Publication Number: 2766.TOP 14

Tami N. Hill, St. Christopher's Hospital for Children, Philadelphia, PA, United States; Natalie C. O'Toole, St. Christopher's Hospital for Children, Philadelphia, PA, United States; Sogand Karimian, Drexel University College of Medicine, Philadelphia, PA, United States; Noah Buboltz, St. Christopher's Hospital for Children, Philadelphia, PA, United States

Background: Prenatal substance exposure is a significant public health concern with potential long-term implications for child health and development. This issue is particularly pressing in underserved urban communities, where socioeconomic factors may exacerbate effects of such exposure. A 2019 national analysis by the CDC utilized data from the Pregnancy Risk Assessment Monitoring System (PRAMS) to survey behaviors during pregnancy. Analysis found 6.6% of birthing persons reported opioid use during pregnancy. When PRAMS data is stratified to the Philadelphia sub-state and time period of this ongoing study, 3.6% and 3.7% reported opioid use during pregnancy in 2021 and 2022, respectively.
A 2020 study conducted by the National Survey on Drug Use and Health (NSDUH) found nearly 20% of birthing persons reported cannabis, tobacco, alcohol or illicit substance use during pregnancy. PRAMS data for Philadelphia found 7.5% and 5.5% reported use of substances such as cannabis and amphetamines; 6.8% and 4.7% reported cigarette use; and 8.3% and 6.4% reported alcohol use in 2021 and 2022, respectively.

Objective: The purpose of this retrospective quality improvement study is to analyze trends in prenatal substance exposure among pediatric patients within an urban academic medical center in North Philadelphia and its surrounding suburbs. This study aims to identify patterns and associated outcomes of infants of prenatal substance exposure, including demographic information and developmental and maternal health screeners, thereby informing future interventions and support strategies for affected children.

Design/Methods: This study utilized a retrospective analysis of Electronic Health Record (EHR) data from St. Christopher's Hospital for Children, focusing on patients born between 2021-2023. Data was extracted using ICD-10 codes related to prenatal substance exposure, including conditions such as Neonatal Abstinence Syndrome (NAS) and exposure to substances like opiates, cannabis, and hallucinogens. The data collected included demographic information (e.g., age, sex, race, ethnicity, zip code, insurance status) and standardized assessment scores (Survey of Well-being of Young Children (SWYC), Modified Checklist of Autism in Toddlers (M-CHAT), (Edinburgh Postnatal Depression Scale (EPDS)). Statistical analyses will be conducted with the aim of identifying significant trends and associations within the study population. Initial demographic data was obtained (see Figure 1). Analysis regarding development, previous parental mental health, and other factors is currently ongoing.

Pediatric Patient Demographic Data
Figure 1 displays the racial and ethnic classifications of the study population.