{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T08:51:36Z","timestamp":1781859096660,"version":"3.54.5"},"posted":{"date-parts":[[2026,5,29]]},"group-title":"Pediatrics","reference-count":34,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T00:00:00Z","timestamp":1780012800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Institutes of Health\u2019s National Center for Advancing Translational Sciences","award":["UM1TR004405"],"award-info":[{"award-number":["UM1TR004405"]}]},{"name":"University of Minnesota\u2019s Data Science Initiative, Children\u2019s Discovery Fund"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,6,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>\n                    Prenatal substance exposure (PSE) occurs when an individual is exposed to substances\n                    <jats:italic>in utero.<\/jats:italic>\n                    PSEs may have lasting effects on mental health. We tested whether PSEs show threshold, cumulative, or individual substance associations with childhood psychiatric diagnoses.\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Clinical variables (demographics, ICD-9\/10 diagnoses, PSE history) were extracted from electronic health records from the University of Minnesota Adoption Medicine Clinic. PSEs were identified from caregiver and child-protective-services narratives and\/or toxicology (cord tissue\/blood, meconium). For each ICD-9\/10 diagnostic category, we fit logistic regression models comparing (1) exposure thresholds (0, 1, 2, 3, \u22654 exposures), (2) a cumulative exposure count, and (3) individual substances to estimate marginal odds ratios (ORs) with 95% Confidence Intervals (CIs).<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Psychiatric diagnoses increased with the number of PSEs. Relative to no exposure, odds of an Anxiety Disorder rose from OR 1.47 (95% CI 1.16\u20131.87) with one exposure to OR 2.03 (1.64\u20132.52) with \u22654 exposures. Higher cumulative exposure scores were associated with Anxiety Disorders (OR 1.28, 1.18\u20131.38), Behavioral and Emotional Disorders (OR 1.42, 1.31\u20131.54), Substance Use Disorders (OR 1.52, 1.29\u20131.79), and Mood Disorders (OR 1.16, 1.04\u20131.30). Alcohol, tobacco, and marijuana exposures were associated with increased odds of at least one psychiatric diagnosis, and each substance showed at least one significant diagnostic cluster when modeled independently.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Increasing numbers of PSEs were associated with higher odds of psychiatric diagnoses, with patterns varying by substance and outcome. These findings motivate research on exposure timing and combinations to support earlier identification and intervention for at-risk children.<\/jats:p>\n                <\/jats:sec>","DOI":"10.64898\/2026.05.27.26354273","type":"posted-content","created":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T21:20:21Z","timestamp":1780089621000},"source":"Crossref","is-referenced-by-count":0,"title":["Before Birth, Beyond Childhood: Understanding the Influence of Prenatal Substance Exposure on Psychiatric Diagnoses"],"prefix":"10.64898","author":[{"given":"Logan","family":"Caola","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evan","family":"Dastin-Van Rijn","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shelby","family":"Anderson","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erich","family":"Kummerfeld","sequence":"additional","affiliation":[{"name":"Institute for Health Informatics, University of Minnesota, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christi","family":"Sullivan","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefanie","family":"Simpson","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aarav","family":"Kalkar","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA"},{"name":"Institute for Health Informatics, University of Minnesota, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ritwick","family":"Banerjee","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA"},{"name":"Institute for Health Informatics, University of Minnesota, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Audrey","family":"Houghton","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Fiecas","sequence":"additional","affiliation":[{"name":"School of Public Health, Division of Biostatistics & Health Data Science, University of Minnesota, Minneapolis, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anita C","family":"Randolph","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"54368","reference":[{"issue":"1","key":"2026061901000758000_2026.05.27.26354273v2.1","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1097\/GRF.0000000000000418","article-title":"Stimulant Use in Pregnancy: An Under-recognized Epidemic Among Pregnant Women","volume":"62","year":"2019","journal-title":"Clin Obstet Gynecol"},{"issue":"6","key":"2026061901000758000_2026.05.27.26354273v2.2","doi-asserted-by":"crossref","first-page":"2175","DOI":"10.3390\/jcm12062175","article-title":"Perinatal Psychoactive Substances Use: A Rising Perinatal Mental Health Concern","volume":"12","year":"2023","journal-title":"J Clin Med"},{"issue":"2","key":"2026061901000758000_2026.05.27.26354273v2.3","first-page":"265","article-title":"Infants, children, and youth in foster care with prenatal substance exposure: a synthesis of two scoping reviews","volume":"69","year":"2021","journal-title":"Int J Dev Disabil"},{"key":"2026061901000758000_2026.05.27.26354273v2.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.chiabu.2017.10.002"},{"key":"2026061901000758000_2026.05.27.26354273v2.5","unstructured":"Hudak M. 48: Infants of Substance-Using Mothers. 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