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.