Identification during the postpartum period of infants who are at high risk of child maltreatment.
Identification during the postpartum period of infants who are at high risk of child maltreatment.
复制标题
产后识别有遭受虐待儿童高风险的婴儿。
DOI：
10.1016/s0022-3476(89)80580-3
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发表时间：
1989
期刊：
影响因子：
--
通讯作者：
C. A. Brady
中科院分区：
文献类型：
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作者：
J. Leventhal;R. Garber;C. A. Brady
为了确定临床医生是否正确识别出儿童虐待高风险的新生儿，我们检查了高风险和非高风险儿童的结果。1979年至1981年在耶鲁纽黑文医院出生的婴儿，在产后期间被临床医生转诊到医院的虐待儿童登记处，因为他们被认为是虐待或忽视儿童的高风险人群。对于每一个高危婴儿，根据出生日期、性别、种族和住院支付方式选择并匹配一个对照婴儿。对于这两组儿童，通过审查儿童4岁生日之前的医疗记录，确定虐待的发生情况。每一个寻求医疗护理的伤害都被一个不知道孩子风险状况的儿科医生分为七类（从明确的虐待儿童到事故）。还记录了关于非器质性发育不良和儿童看护人变化的信息。虐待（定义为虐待或忽视）在高风险组比对照组更频繁发生（调整后的匹配比值比=4.3; 95%置信区间=1.41，6.93;p<0.001），非器质性原因导致的体重增加不良也是如此。（匹配优势比=7.0; 95%置信区间=1.59，30.79;p<0.01）和儿童看护人的变化（匹配优势比=9.0; 95%置信区间=3.80; 20.55;p<0.001）。我们的结论是，早在产后期间，临床医生可以确定一些家庭谁是虐待和其他主要不良后果的高风险造成不良的养育。
To determine whether clinicians correctly identify newborn infants who are at high risk of child maltreatment, we examined the outcomes of high-risk and non-high-risk children. Infants who were born at Yale-New Haven Hospital from 1979 to 1981 and who were referred by clinicians during the postpartum period to the hospital's child abuse registry because they were considered at high risk of child abuse or neglect became the high-risk group. For each high-risk infant, a comparison infant was selected and matched according to date of birth, gender, race, and method of payment for the hospitalization. For both groups, the occurrence of maltreatment was ascertained by reviewing the medical records until the child's fourth birthday. Each injury for which medical care was sought was classified into one of seven categories (from definite child abuse to accident) by a pediatrician who was unaware of the child's risk status. Information also was recorded about nonorganic failure to thrive and changes in the child's caretaker. Maltreatment (defined as abuse or neglect) occurred more frequently in the high-risk group than the comparison group (adjusted matched odds ratio=4.3; 95% confidence interval=1.41, 6.93;p<0.001), as did poor weight gain from a nonorganic cause (matched odds ratio=7.0; 95% confidence interval=1.59, 30.79;p<0.01) and changes in the child's caretaker (matched odds ratio=9.0; 95% confidence interval=3.80; 20.55;p<0.001). We conclude that as early as the postpartum period, clinicians can identify some families who are at high risk of maltreatment and other major adverse outcomes resulting from poor parenting.