528 Influence of prenatal substance exposure and adverse childhood experiences on long-term mental and physical health in offspring

Objectives/Goals: 1. Determine if adverse childhood experiences in our novel database are associated with adverse mental and physical health outcomes. 2. Assess differences in developmental and neuropsychological functioning in children with PME and/or opioid exposure. 3. Predict long-term impact of prenatal METH, opioid, and co-use exposures on cognitive development. Methods/Study Population: The Minnesota Foster Care and Adoption Population-level Database includes demographics, birth data (date of birth, gestational age, birth weight, birth length), medical visits and hospital admissions, growth measures over time (height, weight, BMI, and head circumference),vitals, labs, ICD diagnoses, type of prenatal substance exposure (PSE), ACEs (PEARL standards), caregiver placement types (adoption, traditional foster care, kinship care, institutional care, orphanage care, respite care), number of caregiver transitions, and risky behaviors (being detained, suicidal ideation or attempt, self-injurious behaviors, and substance use). Results/Anticipated Results: The study includes 2,725 participants, comprising both adopted children and those in various foster care settings. Transitions are frequent, with only 17% of participants experiencing no transitions. The most common numbers of transitions are two (10%), four (10%), five (9.8%), and six (9.7%). The leading adverse childhood experiences are household substance abuse, mental illness, physical neglect, domestic violence, and physical abuse. Alcohol, tobacco, and methamphetamine are the most frequently used substances during pregnancy, a trend that persists with polysubstance exposure. Adverse childhood experiences are linked to ADHD, conduct disorders, depression, anxiety, mood disorders, and adjustment disorders. Discussion/Significance of Impact: Our findings could help identify a comprehensive profile of developmental and neuropsychological functioning in PSE populations. Our strongest asset is our database, which controls environmental factors better than the general population when we study neurodevelopmental outcomes of PSE.