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Infant Deaths From Medical Causes After a Maltreatment Report
Janet U Schneiderman1, John Prindle2, Emily Putnam-Hornstein2,3
1Department of Nursing, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California juschnei@usc.edu.
Pediatrics
|August 24, 2021
Summary
Infants reported for maltreatment face a significantly higher risk of medical-related death. Foster care placement was found to be protective, reducing this risk by approximately half.
Area of Science:
- Pediatric Health
- Child Welfare
- Public Health
Background:
- Infants reported for maltreatment may face increased health risks.
- Understanding medical causes of infant mortality is crucial for targeted interventions.
Purpose of the Study:
- To investigate the association between maltreatment reports and medical causes of postneonatal infant death.
- To assess the protective effect of foster care placement on infant mortality risk.
Main Methods:
- Linked birth/death records with child protection records for California infants (2010-2016).
- Used time-varying covariates to model maltreatment reports and foster care placement.
- Employed competing risk models to estimate hazard ratios for medical-related infant death.
Main Results:
- Infants with one maltreatment report had 1.77 times higher medical-related mortality risk.
- Infants with more than one report had 3.27 times higher risk.
- Foster care placement reduced mortality risk by approximately 50% among infants reported for maltreatment.
Conclusions:
- Infants reported for maltreatment exhibit a heightened risk of death from medical causes.
- Foster care placement demonstrates a protective effect against medical-related infant mortality.
- Enhanced support services and inter-agency communication are vital for medically fragile infants at home post-allegation.
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