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Published on: August 25, 2014
Risk factors for infant maltreatment: a population-based study
Samuel S Wu1, Chang-Xing Ma, Randy L Carter
1Department of Biostatistics, University of Florida, Gainsville, FL, USA.
Insights
Infant maltreatment is linked to maternal smoking, multiple siblings, Medicaid enrollment, unmarried status, and low birth weight. Identifying these risk factors can help prioritize prevention programs for vulnerable infants.
Area of Science:
- Pediatrics
- Public Health
- Child Welfare
Background:
- Infant maltreatment is a significant public health concern, with the youngest children being disproportionately affected.
- In 2002, children under one year old constituted the largest percentage of child abuse and neglect victims in the US.
Purpose of the Study:
- To identify key perinatal and sociodemographic risk factors associated with maltreatment in infants up to 12 months of age.
- To inform targeted interventions for infant abuse and neglect prevention.
Main Methods:
- An observational cohort study was conducted using data from 189,055 children born in Florida in 1996.
- Infant maltreatment was defined as verified reports of abuse, neglect, or threatened harm occurring between 3 days and 1 year of life.
Main Results:
- Of the 1996 birth cohort, 0.85% experienced verified maltreatment by age one.
- Eleven of fifteen perinatal and sociodemographic variables were significantly associated with infant maltreatment.
- Key risk factors included maternal smoking during pregnancy (RR 2.8), more than two siblings (RR 2.7), Medicaid beneficiary status (RR 2.1), unmarried marital status (RR 2.0), and low birth weight (RR 2.0).
- Infants with four of these five risk factors had a sevenfold higher maltreatment rate.
Conclusions:
- Significant risk factors for infant maltreatment are often recorded on birth certificates.
- A population-based risk-assessment tool using birth certificate data can identify high-risk infants.
- Prioritizing these high-risk groups for child abuse prevention programs is crucial due to limited resources.
Context:
Of the approximately 900,000 children who were determined to be victims of abuse or neglect by US child protective services in 2002, the birth-to-3 age group had the highest rate of victimization (1.6%) and children younger than 1 accounted for the largest percentage of victims (9.6%).
Objective:
To identify perinatal and sociodemographic risk factors associated with maltreatment of infants up to 1 year of age.
Design And Setting:
Observational cohort study.
Participants:
189,055 children born in 1996 in Florida.
Main Outcome Measure:
Infant maltreatment, defined as a verified report of abuse, neglect, or threatened harm that occurred between day 3 of life and 1 year.
Results:
1,602 children (.85%) of the 1996 birth cohort had verified instances of maltreatment by age 1. Of 15 perinatal and sociodemographic variables studied, 11 were found to be significantly related to infant maltreatment. Five factors had adjusted relative risks (RR) of two or greater: Mother smoked during pregnancy (RR 2.8); more than two siblings (RR 2.7); Medicaid beneficiary (RR 2.1); unmarried marital status (RR 2.0); low birth weight infant (RR 2.0). Infants who had four of these five risk factors had a maltreatment rate seven times higher than the population average.
Conclusions:
Data on nearly all risk factors found to be significantly associated with infant maltreatment are available on the birth certificate. Such information can be incorporated into a population-based risk-assessment tool that could identify subpopulations at highest risk for infant maltreatment. Because resources are limited, these groups should be given priority for enrollment in child abuse prevention programs.
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