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This study applied a validated medical record data extraction tool on data derived from a multi-site (\n                    <jats:italic toggle=\"yes\">N<\/jats:italic>\n                    = 30) pediatric clinical trials network (ISPCTN) study of Neonatal Opioid Withdrawal (ACT NOW study). Participants included 1808 birthing parent-infant dyads with documented NOWS scoring or prenatal opioid exposure. Non-Hispanic White pregnant persons comprised the largest proportion of the sample (69.8%), followed by Non-Hispanic Black (11.6%), Non-Hispanic Multiracial and Other race (8.5%), and Hispanic (6.2%). Most notably, infant prenatal substance exposure across alcohol, cocaine, meth\/amphetamine, and opioids, had the lowest possibility of discharging to parent(s). Additionally, latent class analysis identified distinct classes of substance use during pregnancy that were associated with different probabilities of discharging to parent(s). Specifically, less than half of infants (47%\u201349%) in the Poly-use and Meth\/amphetamine classes were discharged to their parent(s). Severity of infant withdrawal symptoms influenced placement decisions within the Poly-use and Prescription Opioid classes. Findings can inform standard practices for increasing support for pregnant persons and substance-exposed infants including identification, subsequent referrals, communication with Child Protective Services, and plans of safe care.\n                  <\/jats:p>","DOI":"10.1177\/10775595241289894","type":"journal-article","created":{"date-parts":[[2024,10,8]],"date-time":"2024-10-08T08:40:05Z","timestamp":1728376805000},"page":"707-717","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Prenatal Substance Exposure and Infant Discharge Placement: Results From the ACT NOW Study"],"prefix":"10.1177","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7462-8798","authenticated-orcid":false,"given":"Tre D.","family":"Gissandaner","sequence":"first","affiliation":[{"name":"Columbia University Irving Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordan A.","family":"Gette","sequence":"additional","affiliation":[{"name":"The State University of New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin J.","family":"Perry","sequence":"additional","affiliation":[{"name":"The Pennsylvania State University"},{"name":"University of Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alainna","family":"Wen","sequence":"additional","affiliation":[{"name":"University of California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Regan","sequence":"additional","affiliation":[{"name":"Johns Hopkins Bloomberg School of Public Health"},{"name":"Uniformed Services University of the Health Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren M.","family":"Mutignani","sequence":"additional","affiliation":[{"name":"University of Rochester Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2090-7828","authenticated-orcid":false,"given":"Dustin E.","family":"Sarver","sequence":"additional","affiliation":[{"name":"University of Mississippi Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Crystal S.","family":"Lim","sequence":"additional","affiliation":[{"name":"University of Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert D.","family":"Annett","sequence":"additional","affiliation":[{"name":"University of New Mexico Health Sciences Center"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,10,7]]},"reference":[{"key":"e_1_3_5_2_1","doi-asserted-by":"publisher","DOI":"10.1080\/10705511.2020.1764360"},{"key":"e_1_3_5_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/1077559521990116"},{"key":"e_1_3_5_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.earlhumdev.2018.10.010"},{"key":"e_1_3_5_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.2517-6161.1995.tb02031.x"},{"key":"e_1_3_5_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/pan\/mph001"},{"issue":"2","key":"e_1_3_5_7_1","first-page":"37","article-title":"Ecological models of human development","volume":"3","author":"Bronfenbrenner U.","year":"1994","unstructured":"Bronfenbrenner U. 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