ADEF Helsinki

ADEF Helsinki - alcohol or drug exposure during fetal life

ADEF Helsinki -study investigates the overall developmental outcomes of adolescents and young adults with prenatal substance exposure and the effect of the dual exposure to substances and adverse childhood experiences on these outcomes.

Hundreds of children with prenatal substance exposure are born in Finland every year. Prenatal alcohol exposure can impair the normal development of the fetus resulting in central nervous system dysfunction and physical damage with several lifelong health consequences. Prenatal exposure to illicit drugs may have similar consequences but the research evidence is incongruous. A majority of affected children live in an unstable caregiving environment, which increases the risk of developmental problems. How these children are managing later in life? This study sheds light on this question.

The longitudinal register-based cohort study 1) compares the overall developmental outcomes (e.g. mental and behavioral disorders, somatic diseases, education, and income support) of youth aged 15-24 years with prenatal substance exposure (n=615) and matched unexposed age-mates (n=1787), and 2) investigates risk and protective factors associated with these developmental outcomes.

The exposed youth were born in 1992-2001 to mothers with a significant substance misuse problem during pregnancy. The mothers were identified by public health nurses in primary care maternity clinics in the Helsinki metropolitan area and referred for intensified pregnancy follow-up in the three special antenatal clinics at the Helsinki University Hospital. Hospital medical records collected during the pregnancy follow-up were reviewed and the data were linked with register data from the several national health and social welfare registers collected for each mother-child dyad from birth until the end of 2015-2018. Similar register data were gathered for matched mother-child dyads without any sign of the mother’s substance misuse in national health and social welfare registers. The additional matching criteria were the same maternal age, parity, number of fetuses, and a month of birth and a delivery hospital of the index child. The present study is the second follow-up of the cohort.

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Anne M. Koponen, PI, PhD, Adjunct Professor of Social Psychology

Nissinen, N-M., Rangmar, J., Autti-Rämö, I., Gissler, M., Kahila, H., Raitasalo, K., & Sarkola, T. (2023). Financial difficulties among youth prenatally exposed to substances: a longitudinal register-based cohort study. Drugs: Education, Prevention and Policy https://doi.org/10.1080/09687637.2023.2176285

Nissinen, N-M., Sarkola, T., Autti-Rämö, I., Gissler, M. Kahila, H., & Koponen, A. M. (2022). Mood and neurotic disorders among youth with prenatal substance exposure: A longitudinal register-based matched cohort study. Journal of Affective Disorders, 308,328-336.

Koponen, A. M, Nissinen, N-M., Gissler, M., Kahila, H., Autti-Rämö, I. & Sarkola, T. (2022). Out-of-home care and diagnosed mental and behavioral disorders among youth with and without prenatal substance exposure: A longitudinal register-based cohort study. Children and Youth Services Review, 143, December 2022, 106683.

Koponen, A. M., Nissinen, N-M., Gissler, M., Autti-Rämö, I., Kahila, H. & Sarkola (2022). Adverse childhood experiences and neurodevelopmental disorders among youth with and without prenatal substance exposure: A longitudinal matched register-based cohort study. Nordic Studies on Alcohol & Drugs, December 19.

Koponen, A. M., Nissinen, N-M., Gissler, M., Autti-Rämö, I., Sarkola, T. & Kahila, H. (2020). Prenatal substance exposure, adverse childhood experiences and diagnosed mental and behavioral disorders - a longitudinal register-based matched cohort study in Finland. SSM Population Health, 11, 100625.  

Koponen, A. M., Nissinen, N-M., Gissler, M., Sarkola, T., Autti-Rämö, I. & Kahila, H. (2020). Cohort profile: ADEF Helsinki - a longitudinal register-based study on exposure to alcohol and drugs during fetal life. Nordic Studies on Alcohol and Drugs, 37(1). First published: December 30.https://doi.org/10.1177/1455072519885719

Koponen, A. M., Nissinen, N-M. (2019). Vähäinenkin alkoholinkäyttö raskausaikana lisää sikiövaurion riskiä. [Even slight alcohol use during pregnancy increases the risk of fetal damage.] PopNAD, Alkoholi- ja huumetutkimusta käsittelevä populaaritieteellinen verkkosivusto, 14.11.2019. 

Nissinen, N-M., Kahila, H., Gissler, M., Sarkola, T., Autti-Rämö, I., & Koponen, A. (2020). Completed secondary education among youth with prenatal substance exposure: A longitudinal register-based matched cohort study. Journal of Adolescence, 86, January 2021, 15-27.

Kahila, H. et al. (2007). A prospective study on buprenorphine use during pregnancy: effects on maternal and neonatal outcome. Acta Obstetricia et Gynecologica, 86, 185-190.

Kahila, H., Gissler, M., Sarkola, T., Autti-Rämö, I., & Halmesmäki, E. (2010). Maternal welfare, morbidity and mortality 6-15 years after a pregnancy complicated by alcohol and substance abuse: A register-based case-control follow-up study of 524 women. Drug and Alcohol Dependence, 111, 215-221.

Sarkola, T., Gissler, M., Kahila, H., Autti-Rämö, I., & Halmesmäki, E. (2011). Early healthcare utilization, and welfare interventions among children of mothers with alcohol and substance abuse: a retrospective study. Acta Paediatrica, 100,1379-1385.

Sarkola, T., Gissler, M., Kahila, H., Autti-Rämö, I., & Halmesmäki, E. (2012). Alcohol and substance abuse identified during pregnancy: maternal morbidity, child morbidity, and welfare interventions. Acta Paediatrica, 101,784-790.

Sarkola, T., Kahila, H., Gissler, M., & Halmesmäki, E. (2007). Risk factors for out-of-home custody child care among families with alcohol and substance abuse problems. Acta Paediatrica, 96, 1571-1576.

Koponen, A. M., Kalland, M. & Autti-Rämö, I. (2009). Caregiving environment and socio-emotional development of foster-placed FASD-children. Children and Youth Services Review, 31, 1049-1056.

Koponen, A. M., Kalland, M., Autti-Rämö, I., Laamanen, R., & Suominen, S. (2013). Socio-emotional development of children with Foetal Alcohol Spectrum Disorders in long-term foster family care: A qualitative study. Nordic Social Work Research, 3(1), 38-58.

Hanna Kahila, MD, PhD

Mika Gissler, PhD, Research Professor

Ilona Autti-Rämö, MD, PhD, Research Professor

Taisto Sarkola, MD, PhD, Adjunct Professor

Juho Vainio Foundation

Signe and Ane Gyllenberg Foundation

Medicinska Understödsföreningen Liv och Hälsa

Finnish Foundation for Alcohol Studies

Alli Paasikivi Foundation

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    • Anne Maarit Koponen

      PhD, Senior Scientist

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