In a sample of 513 infants born at a Chicago medical center from 1985 through 1990, 480 (93.6 percent) had complete sociodemographic data available for analysis. Identifying data were used to search the Illinois death registry and a computerized central registry of child abuse reports. Both out-of-home placement and death were distinctly more likely if children had been exposed to drugs and maltreated. The study found that almost one-third of substance-exposed infants had out-of-home placements. Child maltreatment significantly increased the likelihood of placement. No other maternal or infant variable could distinguish the children placed by child protective services from those who were not placed by that agency. The death rate for infants exposed in utero to drugs was higher than the race-specific rates for the country. Tables, references