Latent Class Analysis of Prenatal Substance Exposure and Child Behavioral Outcomes

Program collaborators for Environmental influences on Child Health Outcomes (ECHO)

doi:10.1016/j.jpeds.2023.113468

Latent Class Analysis of Prenatal Substance Exposure and Child Behavioral Outcomes

Program collaborators for Environmental influences on Child Health Outcomes (ECHO)

Mailman School of Public Health

Research output: Contribution to journal › Article › peer-review

Abstract

Objectives: To predict behavioral disruptions in middle childhood, we identified latent classes of prenatal substance use. Study design: As part of the Environmental influences on Child Health Outcomes Program, we harmonized prenatal substance use data and child behavior outcomes from 2195 women and their 6- to 11-year-old children across 10 cohorts in the US and used latent class–adjusted regression models to predict parent-rated child behavior. Results: Three latent classes fit the data: low use (90.5%; n = 1986), primarily using no substances; licit use (6.6%; n = 145), mainly using nicotine with a moderate likelihood of using alcohol and marijuana; and illicit use (2.9%; n = 64), predominantly using illicit substances along with a moderate likelihood of using licit substances. Children exposed to primarily licit substances in utero had greater levels of externalizing behavior than children exposed to low or no substances (P = .001, d = .64). Children exposed to illicit substances in utero showed small but significant elevations in internalizing behavior than children exposed to low or no substances (P < .001, d = .16). Conclusions: The differences in prenatal polysubstance use may increase risk for specific childhood problem behaviors; however, child outcomes appeared comparably adverse for both licit and illicit polysubstance exposure. We highlight the need for similar multicohort, large-scale studies to examine childhood outcomes based on prenatal substance use profiles.

Original language	English
Article number	113468
Journal	Journal of Pediatrics
Volume	260
DOIs	https://doi.org/10.1016/j.jpeds.2023.113468
Publication status	Published - Sept 2023

Bibliographical note

Publisher Copyright:
© 2023 Elsevier Inc.

Funding

This work was supported by the Environmental influences on Child Health Outcomes (ECHO) program, Office of The Director, National Institutes of Health, under award numbers U2COD023375 (Coordinating Center), U24OD023382 (Data Analysis Center), U24OD023319 (PRO Core), 5UH3OD023320-05 (to J.A.), UG3OD023337 (to R.W.), UH3OD023268 (to Litonjua), 4UH3OD023248-03 (to D.D.), 5UH3OD023348-05 (to M.O.), 4UH3OD023328-03 (to C.D.), UH3OD023279 (to A.E.), 4UH3OD023342 (to C.N.), UH3OD023289 (to A.F., L.C.), 4UH3OD023365-03 (to I.H.), 4UH3OD023244-03 (to A.H.), 4UH3OD023275-03 (to M.K.), UH3OD023347 (to B.L.), 5TUH3OD023347 (to C.M.), UH3 OD023389 (to L.L.), UH3OD023349 (to T.O.), R01 HD 034568 and UH3OD 023286 (to E.O.), 4UH3OD023271-03 (to C.K., S.S.), UH3 OD023285 (to N.P.), and 4UH3OD023282-03 (to J.G.). The study sponsor had no role in the study design; the collection, analysis, and interpretation of data; the writing of the report; or the decision to submit the manuscript for publication. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors declare no conflicts of interest.

Funders	Funder number
National Institutes of Health	4UH3OD023282-03, 4UH3OD023365-03, 5UH3OD023348-05, UH3OD023349, U24OD023319, UH3OD023347, UH3OD023268, UH3OD023279, UH3OD023289, UG3OD023337, UH3OD 023286, U2COD023375, 4UH3OD023328-03, UH3 OD023285, 4UH3OD023271-03, 4UH3OD023244-03, 4UH3OD023248-03, 4UH3OD023342, 4UH3OD023275-03, U24OD023382, UH3 OD023389, R01 HD 034568, 5UH3OD023320-05
Office of the Director

ASJC Scopus Subject Areas

Pediatrics, Perinatology, and Child Health

Access to Document

10.1016/j.jpeds.2023.113468

Cite this

@article{1b124f81945b4003b90666ddfd53f6a3,

title = "Latent Class Analysis of Prenatal Substance Exposure and Child Behavioral Outcomes",

abstract = "Objectives: To predict behavioral disruptions in middle childhood, we identified latent classes of prenatal substance use. Study design: As part of the Environmental influences on Child Health Outcomes Program, we harmonized prenatal substance use data and child behavior outcomes from 2195 women and their 6- to 11-year-old children across 10 cohorts in the US and used latent class–adjusted regression models to predict parent-rated child behavior. Results: Three latent classes fit the data: low use (90.5%; n = 1986), primarily using no substances; licit use (6.6%; n = 145), mainly using nicotine with a moderate likelihood of using alcohol and marijuana; and illicit use (2.9%; n = 64), predominantly using illicit substances along with a moderate likelihood of using licit substances. Children exposed to primarily licit substances in utero had greater levels of externalizing behavior than children exposed to low or no substances (P = .001, d = .64). Children exposed to illicit substances in utero showed small but significant elevations in internalizing behavior than children exposed to low or no substances (P < .001, d = .16). Conclusions: The differences in prenatal polysubstance use may increase risk for specific childhood problem behaviors; however, child outcomes appeared comparably adverse for both licit and illicit polysubstance exposure. We highlight the need for similar multicohort, large-scale studies to examine childhood outcomes based on prenatal substance use profiles.",

author = "{Program collaborators for Environmental influences on Child Health Outcomes (ECHO)} and Maylott, {Sarah E.} and Elisabeth Conradt and Monica McGrath and Knapp, {Emily A.} and Xiuhong Li and Rashelle Musci and Judy Aschner and Avalos, {Lyndsay A.} and Croen, {Lisa A.} and Sean Deoni and Karen Derefinko and Amy Elliott and Hofheimer, {Julie A.} and Leve, {Leslie D.} and Madan, {Juliette C.} and Maxwell Mansolf and Murrison, {Liza B.} and Neiderhiser, {Jenae M.} and Sally Ozonoff and Jonathan Posner and Amy Salisbury and Sheela Sathyanarayana and Schweitzer, {Julie B.} and Carl Seashore and Stabler, {Meagan E.} and Young, {Leslie W.} and Ondersma, {Steven J.} and Barry Lester and Smith, {P. B.} and Newby, {K. L.} and Jacobson, {L. P.} and Parker, {C. B.} and R. Gershon and D. Cella and Perera, {F. P.} and Herbstman, {J. B.} and Karagas, {M. R.} and J. Ganiban and A. Ferrara and Croen, {L. A.} and N. Paneth and Kerver, {J. M.} and Ruden, {D. M.} and S. Deoni and D'Sa, {V. A.} and C. Blair and Neiderhiser, {J. M.} and LeWinn, {K. Z.} and Bush, {N. R.} and D. Dabelea",

note = "Publisher Copyright: {\textcopyright} 2023 Elsevier Inc.",

year = "2023",

month = sep,

doi = "10.1016/j.jpeds.2023.113468",

language = "English",

volume = "260",

journal = "Journal of Pediatrics",

issn = "0022-3476",

publisher = "Mosby Inc.",

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TY - JOUR

T1 - Latent Class Analysis of Prenatal Substance Exposure and Child Behavioral Outcomes

AU - Program collaborators for Environmental influences on Child Health Outcomes (ECHO)

AU - Maylott, Sarah E.

AU - Conradt, Elisabeth

AU - McGrath, Monica

AU - Knapp, Emily A.

AU - Li, Xiuhong

AU - Musci, Rashelle

AU - Aschner, Judy

AU - Avalos, Lyndsay A.

AU - Croen, Lisa A.

AU - Deoni, Sean

AU - Derefinko, Karen

AU - Elliott, Amy

AU - Hofheimer, Julie A.

AU - Leve, Leslie D.

AU - Madan, Juliette C.

AU - Mansolf, Maxwell

AU - Murrison, Liza B.

AU - Neiderhiser, Jenae M.

AU - Ozonoff, Sally

AU - Posner, Jonathan

AU - Salisbury, Amy

AU - Sathyanarayana, Sheela

AU - Schweitzer, Julie B.

AU - Seashore, Carl

AU - Stabler, Meagan E.

AU - Young, Leslie W.

AU - Ondersma, Steven J.

AU - Lester, Barry

AU - Smith, P. B.

AU - Newby, K. L.

AU - Jacobson, L. P.

AU - Parker, C. B.

AU - Gershon, R.

AU - Cella, D.

AU - Perera, F. P.

AU - Herbstman, J. B.

AU - Karagas, M. R.

AU - Ganiban, J.

AU - Ferrara, A.

AU - Croen, L. A.

AU - Paneth, N.

AU - Kerver, J. M.

AU - Ruden, D. M.

AU - Deoni, S.

AU - D'Sa, V. A.

AU - Blair, C.

AU - Neiderhiser, J. M.

AU - LeWinn, K. Z.

AU - Bush, N. R.

AU - Dabelea, D.

PY - 2023/9

Y1 - 2023/9

N2 - Objectives: To predict behavioral disruptions in middle childhood, we identified latent classes of prenatal substance use. Study design: As part of the Environmental influences on Child Health Outcomes Program, we harmonized prenatal substance use data and child behavior outcomes from 2195 women and their 6- to 11-year-old children across 10 cohorts in the US and used latent class–adjusted regression models to predict parent-rated child behavior. Results: Three latent classes fit the data: low use (90.5%; n = 1986), primarily using no substances; licit use (6.6%; n = 145), mainly using nicotine with a moderate likelihood of using alcohol and marijuana; and illicit use (2.9%; n = 64), predominantly using illicit substances along with a moderate likelihood of using licit substances. Children exposed to primarily licit substances in utero had greater levels of externalizing behavior than children exposed to low or no substances (P = .001, d = .64). Children exposed to illicit substances in utero showed small but significant elevations in internalizing behavior than children exposed to low or no substances (P < .001, d = .16). Conclusions: The differences in prenatal polysubstance use may increase risk for specific childhood problem behaviors; however, child outcomes appeared comparably adverse for both licit and illicit polysubstance exposure. We highlight the need for similar multicohort, large-scale studies to examine childhood outcomes based on prenatal substance use profiles.

AB - Objectives: To predict behavioral disruptions in middle childhood, we identified latent classes of prenatal substance use. Study design: As part of the Environmental influences on Child Health Outcomes Program, we harmonized prenatal substance use data and child behavior outcomes from 2195 women and their 6- to 11-year-old children across 10 cohorts in the US and used latent class–adjusted regression models to predict parent-rated child behavior. Results: Three latent classes fit the data: low use (90.5%; n = 1986), primarily using no substances; licit use (6.6%; n = 145), mainly using nicotine with a moderate likelihood of using alcohol and marijuana; and illicit use (2.9%; n = 64), predominantly using illicit substances along with a moderate likelihood of using licit substances. Children exposed to primarily licit substances in utero had greater levels of externalizing behavior than children exposed to low or no substances (P = .001, d = .64). Children exposed to illicit substances in utero showed small but significant elevations in internalizing behavior than children exposed to low or no substances (P < .001, d = .16). Conclusions: The differences in prenatal polysubstance use may increase risk for specific childhood problem behaviors; however, child outcomes appeared comparably adverse for both licit and illicit polysubstance exposure. We highlight the need for similar multicohort, large-scale studies to examine childhood outcomes based on prenatal substance use profiles.

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UR - http://www.scopus.com/inward/citedby.url?scp=85161715151&partnerID=8YFLogxK

U2 - 10.1016/j.jpeds.2023.113468

DO - 10.1016/j.jpeds.2023.113468

M3 - Article

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AN - SCOPUS:85161715151

SN - 0022-3476

VL - 260

JO - Journal of Pediatrics

JF - Journal of Pediatrics

M1 - 113468

ER -

Latent Class Analysis of Prenatal Substance Exposure and Child Behavioral Outcomes

Abstract

Bibliographical note

Funding

ASJC Scopus Subject Areas

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