Overall, 1.6% of infants born in this cohort had diagnosed substance exposure (7,428 of 474,071). Exposure varied significantly between racial/ethnic groups (p < .001), with the highest prevalence observed among black infants (4.1%) and the lowest among Hispanic infants (1.0%). Among white and Hispanic infants, the most frequently observed substances were amphetamine and cannabis; for black infants, cannabis was the most common, followed by cocaine. After adjusting for sociodemographic and pregnancy factors, we found that substance exposed black and Hispanic infants were reported to CPS at significantly lower or statistically comparable rates to substance exposed white infants.
Although we were unable to address potential racial/ethnic bias in screening for substances at birth, there was no evidence that racial disparities in infant CPS reports arise from variable responses to prenatal substance exposure. Black and Hispanic newborns with prenatal substance exposure were no more likely than white infants to be reported for maltreatment. Findings held across specific substance types and suggest racial/ethnic reporting disparities are minimized in the presence of prenatal substance exposure.