ABSTRACT
Infants and children with prenatal substance exposure (PSE) experience high rates of child protection system (CPS) involvement.1 Reporting to CPS is often initiated around the time of birth due to concerns about future risk of abuse and neglect, but reporting mandates vary by jurisdiction, state, and/or country and interpretation of these mandates can further vary by hospital and provider.2–5 Few studies have been able to look at cumulative risk of CPS reports, investigations, and substantiated abuse and neglect following PSE throughout childhood because data systems involving administrative claims, CPS data, and substance use records are rarely linked or tracked longitudinally. In this issue of Pediatrics, Powell and colleagues were able to link population-level health, substance use, and CPS data spanning a 12-year period to compare childhood CPS involvement among children with PSE compared with those without in New South Wales (NSW), Australia.6