Maternal pre- and postnatal substance use and attachment in young children: A systematic review and meta-analysis

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 perfor...

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Bibliographic Details
Published in:Development and psychopathology 2022-10, Vol.34 (4), p.1231-1248
Main Authors: Hyysalo, Noora, Gastelle, Marissa, Flykt, Marjo
Format: Article
Language:English
Subjects:
Adaptation
Alcohol
Attachment
Babies
Behavior
Caregivers
Child development
Children
Children & youth
Childrens health
Cocaine
Communication
Drug use
Fetuses
Mental disorders
Mental health
Meta-analysis
Mothers
Narcotics
Parents & parenting
Pregnancy
Prescription drugs
Regular Article
Substance use
Substance use disorder
Systematic review
Teratogenicity
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Summary: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.
ISSN:0954-5794
1469-2198
DOI:10.1017/S0954579421000134