The impact of state prenatal substance use policies on birth outcomes

The researchers are evaluating the impact of punitive, reporting, testing, and supportive policies to address prenatal substance use (PSUPs) on (1) system responses, including child welfare, criminal justice, and healthcare providers, (2) maternal substance use and healthcare behaviors, and (3) maternal and newborn health. The investigators will also examine whether race and ethnicity modifies the strength of the association between PSUPs and the proposed outcomes. Study findings will generate timely knowledge to inform policy approaches for preventing or treating substance use during pregnancy, reducing racial or ethnic disparities in substance-related pregnancy outcomes, and improving maternal and newborn health, as well as the systems that support these populations.


state prenatal substance use policies diagram


The researchers are using a quasi-experimental difference-in-differences framework that leverages the staggered implementation of PSUPs and compares changes in outcomes before and after implementation between PSUP and non-PSUP states. Additionally, four secondary data sources will be used, including the Healthcare Cost and Utilization Project (HCUP), the Pregnancy Risk Assessment Monitoring System (PRAMS), the Treatment Episode Data Set Admissions (TEDS-A), and the National Child Abuse and Neglect Data System (NCANDS).

Pregnant woman sitting on park bench
Grantee and Partner organizations

Joan & Sanford I. Weill Medical College of Cornell University

Grant status
In Progress
Principal investigators
Angelica Meinhofer, PhD
Start date
Award amount
18 months

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