Association of maternal risk factors with infant maltreatment: an administrative data cohort study
Association of maternal risk factors with infant maltreatment: an administrative data cohort study
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DOI：
10.1136/archdischild-2022-325239
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发表时间：
2023-09-27
影响因子：
5.2
通讯作者：
Harron，Katie L.
中科院分区：
文献类型：
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作者：
Smith，Jennifer N.;Guttmann，Astrid;Harron，Katie L.
目的：在加拿大安大略省，我们旨在评估与家访方案常用标准相关的婴儿虐待风险：年轻的产妇年龄、产妇逆境（无家可归、药物滥用、亲密伴侣暴力）、新移民身份和心理健康问题。本回顾性队列研究包括2005年4月1日至2017年3月31日在安大略省医院出生的婴儿，这些婴儿在相关的卫生行政和人口数据库中被捕获。从新生儿住院到1岁，对医疗保健或死亡记录中记录的儿童虐待进行跟踪。使用多变量logistic回归模型分析了母亲风险因素类型和数量与虐待之间的关系，控制了婴儿特征和物质剥夺。进一步的建模探讨了每一年的母亲年龄与虐待的关系。结果989 586例患儿中有虐待记录的434例（0.04%）。与年龄≥22岁的母亲相比，年龄<22岁的母亲发生婴儿虐待的风险更高（调整后的OR (aOR) 5.5, 95% CI 4.5至6.8）。产妇心理健康诊断（aOR 2.0, 95% CI 1.6至2.5）也与虐待有关，而难民身份似乎具有保护作用（aOR 0.6, 95% CI 0.4至1.0）。受虐待的几率随着母亲风险因素的增加而增加。母亲的年龄与28岁前的虐待有关。结论年轻母亲所生的婴儿有更大的婴儿虐待风险，这种关联一直持续到28岁。这些发现对于确保公共卫生干预措施支持遭受结构性脆弱性的人群，以防止虐待具有重要意义。
ObjectiveWe aimed to evaluate the risk of infant maltreatment associated with commonly used criteria for home visiting programmes: young maternal age, maternal adversity (homelessness, substance abuse, intimate partner violence), newcomer status and mental health concerns in Ontario, Canada.DesignThis retrospective cohort study included infants born in hospital in Ontario from 1 April 2005 to 31 March 2017 captured in linked health administrative and demographic databases. Infants were followed from newborn hospitalisation until 1 year of age for child maltreatment captured in healthcare or death records. The association between type and number of maternal risk factors, and maltreatment, was analysed using multivariable logistic regression modelling, controlling for infant characteristics and material deprivation. Further modelling explored the association of each year of maternal age with maltreatment.ResultsOf 989 586 infants, 434 (0.04%) had recorded maltreatment. Maternal age <22 years conferred higher risk of infant maltreatment (adjusted OR (aOR) 5.5, 95% CI 4.5 to 6.8) compared with age ≥22 years. Maternal mental health diagnoses (aOR 2.0, 95% CI 1.6 to 2.5) were also associated with maltreatment, while refugee status appeared protective (aOR 0.6, 95% CI 0.4 to 1.0). The odds of maltreatment increased with higher numbers of maternal risk factors. Maternal age was associated with maltreatment until age 28 years.ConclusionInfants born to young mothers are at greater risk of infant maltreatment, and this association remained until age 28 years. These findings are important for ensuring public health interventions are supporting populations experiencing structural vulnerabilities with the aim of preventing maltreatment.