{
  "abstract": "Discretionary child protection system (CPS) reporting policies allow some substance-exposed infants to be discharged from the hospital without a maltreatment report, but it is unknown whether risk for later system involvement varies according to exposure status. We conducted a retrospective cohort analysis of CPS involvement in the first 5 years of life as predicted by prenatal substance exposure among California births in 2018. At 5 years, less than 14% of exposed children experienced CPS reports of maltreatment harm or substantiated CPS reports. Exposed children were more likely to be reported for maltreatment harm at 5 years (adjusted Risk Difference (aRD)=0.03, 95%CI: 0.02, 0.04), including a subgroup with only cannabis exposure (aRD = 0.03, 95%CI: 0.02, 0.04) compared with unexposed infants. Prenatally exposed children were more likely to experience a substantiated report within 5 years compared with those without exposure (aRD = 0.03, 95%CI: 0.02, 0.03). Findings suggest that families affected by prenatal substance exposure who do not have apparent safety concerns at birth may benefit from support to prevent future instances of system intervention or child maltreatment.",
  "abstract_shown": true,
  "affiliations": [
    "University of North Carolina Chapel Hill School of Social Work, Chapel Hill, North Carolina, United States of America",
    "MassGeneral Hospital for Children, Harvard Medical School, Boston, Massachusetts, United States of America",
    "Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America",
    "Department of Obstetrics & Gynecology, University of North Carolina Chapel Hill, Chapel Hill, North Carolina, United States of America",
    "RAND, Boston, Massachusetts, United States of America",
    "MaineHealth, Portland, Maine, United States of America",
    "Tufts University, Boston, Massachusetts, United States of America",
    "University of North Carolina Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, United States of America"
  ],
  "article_type": "Research Article",
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Julia Reddy"
    },
    {
      "affs": [
        1
      ],
      "name": "Davida M. Schiff"
    },
    {
      "affs": [
        2
      ],
      "name": "Anna Austin"
    },
    {
      "affs": [
        3
      ],
      "name": "Hendree E. Jones"
    },
    {
      "affs": [
        4
      ],
      "name": "Laura J. Faherty"
    },
    {
      "affs": [
        5
      ],
      "name": "Rebecca Rebbe"
    },
    {
      "affs": [
        6
      ],
      "name": "Anissa Vines"
    },
    {
      "affs": [
        7
      ],
      "name": "Emily Putnam-Hornstein"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/anq8prxfgh7pn.bib",
  "cited_by": 0,
  "doi": "10.1371/journal.pone.0357388",
  "fulltext_url": null,
  "id": "anq8prxfgh7pn",
  "issns": [
    "1932-6203"
  ],
  "landing_url": "https://doi.org/10.1371/journal.pone.0357388",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "3311|Child Welfare and Adoption"
    ],
    [
      "plos",
      "/Biology and life sciences/Developmental biology/Neonates"
    ],
    [
      "plos",
      "/Medicine and health sciences/Epidemiology/Medical risk factors"
    ],
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      "plos",
      "/Medicine and health sciences/Health care/Health care facilities/Hospitals"
    ],
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      "plos",
      "/Medicine and health sciences/Pharmacology/Behavioral pharmacology/Drug dependence"
    ],
    [
      "plos",
      "/Medicine and health sciences/Pharmacology/Behavioral pharmacology/Recreational drug use/Cannabis"
    ],
    [
      "plos",
      "/People and places/Population groupings/Age groups/Children/Infants"
    ],
    [
      "plos",
      "/People and places/Population groupings/Ethnicities"
    ],
    [
      "plos",
      "/People and places/Population groupings/Ethnicities/Hispanic people"
    ],
    [
      "plos",
      "/People and places/Population groupings/Families/Children/Infants"
    ]
  ],
  "openalex": "W7214082929",
  "pdf_url": "https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0357388&type=printable",
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-23",
  "publisher": "Public Library of Science",
  "ris": "https://research.draconitic.com/paper/anq8prxfgh7pn.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:43Z",
      "native_id": "10.1371/journal.pone.0357388",
      "source": "plos",
      "url": "https://doi.org/10.1371/journal.pone.0357388"
    }
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  "subjects": [
    {
      "field": "biology",
      "origin": "plos:developmental biology",
      "subfield": "developmental-biology"
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    {
      "field": "medicine",
      "origin": "plos:epidemiology",
      "subfield": "epidemiology-public-health"
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    {
      "field": "medicine",
      "origin": "plos:pharmacology",
      "subfield": "pharmacology-toxicology"
    }
  ],
  "title": "Prenatal substance exposure and 5-year child protection outcomes among infants not reported at birth",
  "title_text": "Prenatal substance exposure and 5-year child protection outcomes among infants not reported at birth",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:43Z",
  "url": "https://research.draconitic.com/paper/anq8prxfgh7pn",
  "venue": "PLOS One",
  "versions": []
}