Maternal substance use has often been associated with insecure and disorganized child attachment. We evaluated this association with a meta-analysis of young children and, further, systematically reviewed mediating and moderating factors between maternal substance use and child attachment. We performed a systematic database search of quantitative English language studies on child attachment that included substance-using mothers and their children below 6 years of age. Eleven studies (N = 1,841) met the inclusion criteria and were included in the meta-analysis of attachment security and seven (N = 1,589) studies were included in the meta-analysis of attachment disorganization. We found that maternal substance use was negatively associated with secure attachment in children, but the effect size was small (r = −.10). The association with disorganized attachment was not significant (r = .15). Related to moderating and mediating factors (k = 6), we found evidence on the role of teratogenic and sociological factors on child attachment. Most importantly, the impact of cumulative risks was vital. However, literature was scarce, and studies varied in risk of bias, leaving many unanswered questions on other potential factors underlying the development of attachment in these high-risk children. We discuss the results considering clinical implications and future directions.

母亲物质使用通常与不安全和杂乱无章的儿童依恋有关。我们通过对幼儿的荟萃分析评估了这种关联，并进一步系统地回顾了母亲物质使用与儿童依恋之间的中介和调节因素。我们对儿童依恋的定量英语语言研究进行了系统的数据库搜索，其中包括使用物质的母亲及其 6 岁以下的孩子。11 项研究 ( N = 1,841) 符合纳入标准并被纳入附件安全性的荟萃分析，7 项研究 ( N= 1,589) 研究被纳入依恋解体的荟萃分析。我们发现母体物质使用与儿童的安全依恋呈负相关，但影响很小（r = -.10）。与杂乱依恋的关联并不显着（r = .15）。与调节和中介因素有关（k= 6），我们发现了关于致畸和社会学因素对儿童依恋的作用的证据。最重要的是，累积风险的影响至关重要。然而，文献很少，研究的偏倚风险也各不相同，对于这些高危儿童依恋发展的其他潜在因素，留下了许多悬而未决的问题。我们讨论了考虑临床意义和未来方向的结果。