Research code: 1403-4-116-32763
Ethics code: IR.IUMS.REC.1403.920
Clinical trials code: مطالعه :ارآزمایی بالینی نیست
Pediatric Growth and Development Research Center, School of Medicine, Iran University of Medical Sciences , elahenorouzimd@gmail.com
Abstract: (213 Views)
Dear Editor
The birth tate of infants born to mothers with drug misuse disorder in Tehran and generally in the world is relatively high and continues to rise, especially in hospitals under the supervision of Iran University of Medical Sciences (1-3). Monitoring the growth and development of these infants after hospital discharge is very important but is often neglected, as it seems that their parents do not provide adequate follow-up regarding nutrition and supplement use. Mandatory visits for vaccination offer an opportunity to assess their growth, development, and care status, which is often overlooked in practice.
Studies outside Iran have reported conflicting results regarding the growth and weight gain of these infants; some found inadequate weight gain due to insufficient care, malnutrition, and improper use of recommended supplements, as well as increased metabolic needs from nervous system irritability and autonomic dysfunction, while others reported excessive weight gain caused by polyphagia and overfeeding to soothe the restlessness of infants born to addicted mothers (4-8).
Given the high prevalence of infants born to addicted mothers in hospitals affiliated with Iran University of Medical Sciences, the lack of similar prior studies in Iran, and conflicting international findings, we designed a retrospective cohort study with ethics code IR.IUMS.REC.1403.920 to assess growth indices (weight, height, head circumference) at birth, 6 months, and 12 months using health center records for infants born to addicted mothers in three hospitals affiliated with Iran University of Medical Sciences (Shahid Akbarabadi, Rasoul Akram, Firoozabadi) from 2019 to 2023, comparing them with a control group. To collect data, mothers' national IDs were extracted from hospital files, linked to infants' IDs, and follow-up growth data were obtained from the SINA system in the Ministry of Health, with authorized access provided by the university's health deputy.
The results of this study were surprising:
Across the three hospitals studied, 263 infants born to addicted mothers were identified, and their birth data (weight, height, head circumference) were within normal expected ranges, indicating appropriate intrauterine growth, which are listed in table 1. However, the most significant finding was that at 6- and 12-month follow-up visits at health centers, data was available for only 2 out of the 263 infants.
The most common reason for lack of follow-up was incorrect or missing phone numbers of mothers, but overall, follow-up failures were due to a combination of factors including unregistered households in SINA system due to single-parenting (67 cases), unidentified mothers (28 cases), incomplete health care records (13 cases), system issues (14 cases), and incorrect or unregistered phone numbers or lack of response (139 cases).
The study showed a high number of infants born to addicted mothers in hospitals affiliated with Iran University, but unfortunately, follow-up on their growth and development in subsequent months was very limited due to reasons such as transfer to welfare organizations, adoption, confidentiality, change of guardianship, inability to track by the mother's national ID, or even illegal sale and identity changes making follow-up impossible.
Due to the sharp decline in follow-up cases at 6 and 12 months, it is not possible to make accurate scientific conclusions about the growth and development trends of infants born to mothers who use drugs during these periods; while birth indicators suggest normal intrauterine growth, the lack of regular monitoring prevents a comprehensive analysis of medium- and long-term outcomes. Indirect findings indicate high levels of social, healthcare, and caregiving deprivation among these infants, with isolation, lack of systematic follow-up, and insufficient supporting care being major barriers to improving the health and well-being of this vulnerable group.
Although this study faced certain limitations, it serves as a serious warning for the health system and highlights the urgent need to design interdisciplinary interventions and implement empowerment programs for at-risk families, aiming to ensure optimal growth and development for infants born to mothers with substance use disorders.
Table 1. Demographic data and growth indices of infants born to addicted mothers in hospitals affiliated with Iran University of Medical Sciences.
The birth tate of infants born to mothers with drug misuse disorder in Tehran and generally in the world is relatively high and continues to rise, especially in hospitals under the supervision of Iran University of Medical Sciences (1-3). Monitoring the growth and development of these infants after hospital discharge is very important but is often neglected, as it seems that their parents do not provide adequate follow-up regarding nutrition and supplement use. Mandatory visits for vaccination offer an opportunity to assess their growth, development, and care status, which is often overlooked in practice.
Studies outside Iran have reported conflicting results regarding the growth and weight gain of these infants; some found inadequate weight gain due to insufficient care, malnutrition, and improper use of recommended supplements, as well as increased metabolic needs from nervous system irritability and autonomic dysfunction, while others reported excessive weight gain caused by polyphagia and overfeeding to soothe the restlessness of infants born to addicted mothers (4-8).
Given the high prevalence of infants born to addicted mothers in hospitals affiliated with Iran University of Medical Sciences, the lack of similar prior studies in Iran, and conflicting international findings, we designed a retrospective cohort study with ethics code IR.IUMS.REC.1403.920 to assess growth indices (weight, height, head circumference) at birth, 6 months, and 12 months using health center records for infants born to addicted mothers in three hospitals affiliated with Iran University of Medical Sciences (Shahid Akbarabadi, Rasoul Akram, Firoozabadi) from 2019 to 2023, comparing them with a control group. To collect data, mothers' national IDs were extracted from hospital files, linked to infants' IDs, and follow-up growth data were obtained from the SINA system in the Ministry of Health, with authorized access provided by the university's health deputy.
The results of this study were surprising:
Across the three hospitals studied, 263 infants born to addicted mothers were identified, and their birth data (weight, height, head circumference) were within normal expected ranges, indicating appropriate intrauterine growth, which are listed in table 1. However, the most significant finding was that at 6- and 12-month follow-up visits at health centers, data was available for only 2 out of the 263 infants.
The most common reason for lack of follow-up was incorrect or missing phone numbers of mothers, but overall, follow-up failures were due to a combination of factors including unregistered households in SINA system due to single-parenting (67 cases), unidentified mothers (28 cases), incomplete health care records (13 cases), system issues (14 cases), and incorrect or unregistered phone numbers or lack of response (139 cases).
The study showed a high number of infants born to addicted mothers in hospitals affiliated with Iran University, but unfortunately, follow-up on their growth and development in subsequent months was very limited due to reasons such as transfer to welfare organizations, adoption, confidentiality, change of guardianship, inability to track by the mother's national ID, or even illegal sale and identity changes making follow-up impossible.
Due to the sharp decline in follow-up cases at 6 and 12 months, it is not possible to make accurate scientific conclusions about the growth and development trends of infants born to mothers who use drugs during these periods; while birth indicators suggest normal intrauterine growth, the lack of regular monitoring prevents a comprehensive analysis of medium- and long-term outcomes. Indirect findings indicate high levels of social, healthcare, and caregiving deprivation among these infants, with isolation, lack of systematic follow-up, and insufficient supporting care being major barriers to improving the health and well-being of this vulnerable group.
Although this study faced certain limitations, it serves as a serious warning for the health system and highlights the urgent need to design interdisciplinary interventions and implement empowerment programs for at-risk families, aiming to ensure optimal growth and development for infants born to mothers with substance use disorders.
Table 1. Demographic data and growth indices of infants born to addicted mothers in hospitals affiliated with Iran University of Medical Sciences.
| variable | number | |
| gender | Girl Boy Unspecified |
108 117 38 |
| Birth hospital | AkbarAbadi FirouzAbadi Rasoul Akram |
124 106 33 |
| Nationality | Iranian Non-Iranian |
228 35 |
| Birth Weight (gr) | 2907 ± 650 | |
| Birth Length (cm) | 46 ± 4.5 | |
| Birth Head Circumference (cm) | 32.88 ± 2.5 | |
Type of Study: Letter to the editor |
Subject:
Pediatric Disease
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