Maternal health, pregnancy and birth outcomes for women involved in care proceedings in Wales: a linked data study.
Maternal health, pregnancy and birth outcomes for women involved in care proceedings in Wales: a linked data study.
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DOI：
10.1186/s12884-020-03370-4
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发表时间：
2020-11-16
影响因子：
3.1
通讯作者：
John A
中科院分区：
文献类型：
--
作者：
Griffiths LJ;Johnson RD;Broadhurst K;Bedston S;Cusworth L;Alrouh B;Ford DV;John A
根据《儿童法》，英国威尔士的地方当局如果担心儿童的福利，可以提起照料诉讼，这可能会导致儿童与父母失去联系。对于有可能失去孩子的母亲，在怀孕期间及时干预可能会避免这种需要，并改善孕产妇/胎儿健康；然而，对这一特定人群在产前期间的情况知之甚少。这项研究调查了婴儿受到护理程序的母亲的产妇特征，目的是针对高危母亲提供预防性干预措施。Cafcass Cymru为威尔士的家庭法院诉讼提供以儿童为重点的建议和支持，其匿名行政数据与安全匿名信息链接数据库中保存的基于人口的产妇和健康记录有关。2015年至2018年期间，有1111名婴儿的生母参与了护理程序，并获得了相关数据。研究结果以年龄剥夺匹配的对照组(n= 23,414)为基准，在此期间不接受护理程序，但获得产科服务。研究对象包括人口学特征、产妇健康、生育史、与助产服务的互动以及妊娠和生育结果。采用了独立性的描述性和统计学检验。队列中一半的妇女(49.4%)生活在最贫困的地区。她们更有可能在进入母亲阶段时更年轻(63.5%； 21 ，对照组为42.7%)，更有可能有心理健康(28.6%对8.2%)和药物使用问题(10.4%对0.6%)，以及在怀孕期间吸烟(62.7%对24.8%)。大多数人在怀孕前三个月首次从事产科服务(63.5%对84.4%)。婴儿更有可能早产(14.2%比6.7%)，足月婴儿出生体重低(8.0%比2.8%)。这项新的关联研究突出了经历过有关婴儿护理程序的孕妇所经历的多种脆弱性。政策和实践方面的同事需要更清楚地了解妇女的需要，才能提供有效的服务，避免家庭法院诉讼和婴儿被带走。
Under the Children Act 1989, local authorities in Wales, UK, can issue care proceedings if they are concerned about the welfare of a child, which can lead to removal of a child from parents. For mothers at risk of child removal, timely intervention during pregnancy may avert the need for this and improve maternal/fetal health; however, little is known about this specific population during the antenatal period. The study examined maternity characteristics of mothers whose infants were subject to care proceedings, with the aim of informing preventative interventions targeted at high risk mothers. Anonymised administrative data from Cafcass Cymru, who provide child-focused advice and support for family court proceedings in Wales, were linked to population-based maternity and health records held within the Secure Anonymised Information Linkage Databank. Linked data were available for 1111 birth mothers of infants involved in care proceedings between 2015 and 2018. Findings were benchmarked with reference to an age-deprivation-matched comparison group (n = 23,414), not subject to care proceedings but accessing maternity services during this period. Demographic characteristics, maternal health, reproductive history, interaction with midwifery services, and pregnancy and birth outcomes were examined. Descriptive and statistical tests of independence were used. Half of the women in the cohort (49.4%) resided in the most deprived areas. They were more likely to be younger at entry to motherhood (63.5% < 21 years-of-age compared to 42.7% in the comparison group), to have mental health (28.6% compared to 8.2%) and substance use issues (10.4% compared to 0.6%) and to smoke (62.7% compared to 24.8%) during pregnancy. The majority first engaged with maternity services within their first trimester of pregnancy (63.5% compared to 84.4%). Babies were more likely to be born preterm (14.2% compared to 6.7%) and, for full-term babies, to have low birthweights (8.0% compared to 2.8%). This novel linkage study highlights multiple vulnerabilities experienced by pregnant mothers who have experienced care proceedings concerning an infant. Policy and practice colleagues require a clearer picture of women’s needs if child protection and health services are to offer effective services which prevent the need for family court proceedings and infant removal.
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DOI：
10.1192/bjp.2019.153
发表时间：
2020-02
期刊：
The British journal of psychiatry : the journal of mental science
影响因子：
--
作者：
Demmler JC;Brophy ST;Marchant A;John A;Tan JOA
通讯作者：
Tan JOA
影响因子：
3.5
作者：
Lyons RA;Jones KH;John G;Brooks CJ;Verplancke JP;Ford DV;Brown G;Leake K
通讯作者：
Leake K
影响因子：
4.5
作者：
John, Ann;McGregor, Joanna;Lloyd, Keith
通讯作者：
Lloyd, Keith
影响因子：
3.7
作者：
Jordan, Sue;Davies, Gareth I.;Humphreys, Ioan
通讯作者：
Humphreys, Ioan
DOI：
10.1016/j.ijmedinf.2016.09.010
发表时间：
2017-01-01
影响因子：
4.9
作者：
Jones, Kerina H.;Laurie, Graeme;Lea, Nathan
通讯作者：
Lea, Nathan