TABLE 4

Race or Ethnicity and Diagnosed Prenatal Substance Exposure as Predictors of a Neonatal Report to CPS Among Black, Hispanic, and White Infants in California in 2006

A. Any SubstanceB. AmphetamineC. CannabisD. OpioidsE. CocaineF. AlcoholG. Neonatal Withdrawal
(53.4% reported)(68.1% reported)(41.1% reported)(62.4% reported)(72.1% reported)(36.1% reported)(56.7% reported)
RR95% CIRR95% CIRR95% CIRR95% CIRR95% CIRR95% CIRR95% CI
Model 1
Substance42.9641.55–44.4141.5940.24–42.9822.0020.87–23.1932.7831.26–34.3837.3135.64–39.0617.8515.98–19.9428.3126.20–30.58
Model 2
Substance35.7733.84–37.8135.8533.98–37.8319.4417.97–21.0327.3825.38–29.5427.6924.83–30.8714.4211.99–17.3522.5520.08–25.32
Race, substance
  Blacka1.151.08–1.211.161.05–1.271.030.91–1.141.020.87–1.171.341.19–1.481.541.21–1.871.220.94–1.50
  Hispanica1.131.08–1.181.050.99–1.100.990.88–1.101.101.01–1.200.940.81–1.080.930.70–1.161.211.04–1.38
Model 3
Substance10.8510.03–11.746.625.97–7.275.574.83–6.324.933.99–5.874.963.61–6.33.562.04–5.093.792.62–4.96
Codocumented substance12.4811.36–13.606.886.15–7.614.884.24–5.525.334.62–6.034.143.20–5.083.532.60–4.454.173.38–4.96
Race, one substance
  Blacka0.960.86–1.060.940.70–1.190.770.61–0.930.880.53–1.240.780.54–1.020.680.02–1.351.220.26–2.18
  Hispanica0.930.85–1.010.950.84–1.060.810.63–1.000.780.58–0.980.880.57–1.190.470.19–0.761.250.70–1.79
Race, codocumented substance
  Blacka0.910.78–1.050.940.72–1.170.770.59–0.951.020.73–1.300.810.58–1.040.920.56–1.270.800.43–1.17
  Hispanica0.900.80–1.000.950.82–1.080.850.68–1.020.880.72–1.040.830.58–1.080.800.50–1.100.840.60–1.08
  • Model 1 presents the ratio of the maltreatment reporting risk for newborns with diagnosed prenatal substance exposure relative to infants without exposure. For example, in Model 1D, findings indicate that newborns with diagnosed in utero exposure to opioids were reported at 32.8 times the rate of those without exposure to opioids (95% CI, 31.26–34.38).

  • Model 2 presents the individual and combined effects of prenatal substance exposure and race or ethnicity. For example, in Model 2E, findings indicate that newborns with diagnosed cocaine exposure were reported at 27.7 times the rate of those without cocaine exposure (95% CI, 24.83–30.87), and black children with diagnosed cocaine exposure were reported at 1.3 times the rate of white children with diagnosed cocaine exposure (95% CI, 1.19–1.48).

  • Model 3 presents the individual and combined effects of prenatal substance exposure and race or ethnicity, after adjustment for other covariates and with findings stratified by whether there was a codocumented substance. For example, in Model 3A, findings indicate that newborns with any diagnosed prenatal exposure for a single substance type were reported at 10.9 times the rate of those without exposure, after adjustment for other covariates (95% CI, 10.03–11.74). For infants with ≥2 substance types diagnosed, they were reported at 12.5 times the rate of those without exposure, after adjustment for other covariates (95% CI, 11.36–13.60). Meanwhile, black children with diagnosed prenatal exposure for a single substance type were 4% less likely to be reported than white children with a single substance type (RR 0.96), a difference that was not statistically significant (95% CI, 0.86–1.06), and again after adjustment for other covariates.

  • a Compared with white infants.