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Updated: May 10, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Special care needs and risk for child maltreatment reports among babies that graduated from the Neonatal Intensive
Raja Nandyal1, Arthur Owora1, Elizabeth Risch1
1Department of Pediatrics, University of Oklahoma Health Sciences Center, USA.
Insights
Caregiving burden increases child welfare reports for Neonatal Intensive Care Unit (NICU) graduates, particularly in the first year. Support is crucial for families with multiple children during this vulnerable period.
Area of Science:
- Pediatrics
- Social Work
- Public Health
Background:
- Neonatal Intensive Care Unit (NICU) graduates face heightened risks of child welfare involvement, including neglect.
- Caregiving burden is a significant factor influencing outcomes for these vulnerable infants.
Purpose of the Study:
- To investigate caregiving burden as a predictor of child welfare reports in NICU graduates.
- To examine the moderating effects of family risk factors on this relationship.
Main Methods:
- Survival analyses were used to link discharge data of 2,463 NICU graduates (2005-2008) with child welfare reports.
- Follow-up occurred at a median of 3.2 years.
Main Results:
- Caregiving burden significantly increased child welfare reporting risk, especially within the first year post-discharge.
- This risk was amplified by having three or more siblings.
- Prior child welfare reports and young maternal age also predicted increased risk.
Conclusions:
- The initial months after NICU discharge represent a critical window for child neglect prevention.
- Targeted caregiver support and monitoring are recommended, especially for families with multiple children.
Abstract:
Newborns discharged from intensive care are at elevated risk for child welfare reports, especially for child neglect. This study investigates the role of caregiving burden as a risk predictor among the NICU graduate population. Discharge data were captured for 2,463 infants graduating from a Neonatal Intensive Care Unit (NICU) during 2005-2008, then linked to child welfare reports at a median 3.2 year follow-up. Survival analyses were used to examine child welfare report outcomes conditional on caregiving burden and its moderating relationships with other family risk factors. Caregiving burden was associated primarily with an increased risk of child welfare reporting during the first few months to first year of life, after which risk was similar to NICU graduates without caregiving burden. Caregiving burden effects were potentiated by having three or more siblings in the family. A history of prior child welfare reports predicted very high risk, regardless of caregiving burden. Young maternal age increased risk. The findings suggest that the immediate months after NICU discharge may be an important window of child neglect prevention opportunity among newborns with special caregiving needs. This may be a key time to provide caregiver support and monitoring, particularly when caregivers have multiple children.
