Introduction

The dual impact of prenatal substance exposure (i.e. alcohol/drugs) and adverse postnatal caregiving environment on offspring secondary education completion is an understudied research area. The aim was to investigate the influence of childhood adversities, out-of-home care, and offspring's mental and/or behavioural disorders on secondary education completion among prenatally exposed offspring in comparison to matched unexposed offspring.

Methods

This is a longitudinal register-based matched cohort study in Finland including offspring with a history of prenatal substance exposure and a matched unexposed cohort. The study sample included 283 exposed and 820 unexposed offspring aged 18–23 years.

Results

The results showed a time lag in secondary education completion and lower educational attainment overall among exposed compared with unexposed (37.8% vs. 51.0%, respectively). The results from the multivariate logistic regression models showed that the differences in the secondary education completion between exposed and unexposed were diminished in the presence of covariates. A cumulative childhood adversity score and out-of-home care were not associated with secondary education completion in the multivariate models, whereas the different domains of offspring's mental and/or behavioural disorders including psychiatric disorders (AOR 0.65, 95% CI 0.45–0.96), neuropsychological disorders (AOR 0.35, 95% CI 0.23–0.54) and dual psychiatric and neuropsychological disorder (AOR 0.29, 95% CI 0.18–0.48) showed an independent negative effect on secondary education completion.

Conclusions

Inferior educational outcomes may not be directly linked with prenatal substance exposure but may rather reflect the extent of evolving offspring's mental and/or behavioural disorders over time influenced by childhood adversities.

中文翻译：

---

产前物质暴露青少年完成中学教育：一项基于纵向登记册的匹配队列研究

介绍

产前物质暴露（即酒精/药物）和不利的产后护理环境对后代完成中等教育的双重影响是一个研究不足的研究领域。目的是与匹配的未暴露后代相比，调查童年逆境、户外护理和后代的精神和/或行为障碍对产前暴露后代完成中学教育的影响。

方法

这是在芬兰进行的一项基于纵向注册的匹配队列研究，包括具有产前物质暴露史的后代和一个匹配的未暴露队列。研究样本包括 283 名暴露的和 820 名未暴露的 18-23 岁的后代。

结果

结果显示，与未暴露者相比，暴露者的中学教育完成时间滞后，总体受教育程度较低（分别为 37.8% 和 51.0%）。多变量逻辑回归模型的结果表明，在存在协变量的情况下，暴露和未暴露之间的中等教育完成率差异减小。在多元模型中，累积的童年逆境得分和户外护理与中学教育完成无关，而后代精神和/或行为障碍的不同领域，包括精神障碍（AOR 0.65，95% CI 0.45–0.96） , 神经心理障碍 (AOR 0.35, 95% CI 0.23–0.54) 和双重精神和神经心理障碍 (AOR 0.29, 95% CI 0.18–0.

结论

较差的教育成果可能与产前物质暴露没有直接关系，而是可能反映了随着时间的推移，受儿童逆境影响而导致后代精神和/或行为障碍的程度。