Developed and validated an instrument for identifying children perceived as vulnerable. Mothers of 1,095 children, aged 4-8 years, completed interviews that included the original 12-item Child Vulnerability Scale. Eight items that correlated best with each of two major variables that contribute to vulnerability were retained in the revised scale and a cutoff score was identified for children perceived as vulnerable. The internal consistency of the revised scale was good. Using the revised scale, 10.1% of children were identified as perceived vulnerable. Children categorized as perceived vulnerable had a significant increase in behavior problems and acute medical visits. The revised Child Vulnerability Scale should be useful in providing a better understanding of the causes and effects of an important factor in child development.
To determine whether mothers with complicated pregnancies are at increased risk of postpartum depression and whether their children are at increased risk of being perceived as vulnerable, the investigators conducted an interview survey of mothers of 1095 children aged 4 to 8 in a community-based sample of primary care pediatric practices. The offspring were viewed as vulnerable by 17% of the women with severe pregnancy complications and 9% of the women without pregnancy complications (relative risk = 1.88; 95% confidence interval = 1.11, 2.63). Women with a severe complication of pregnancy were significantly more likely to report postpartum depression than those without a complication (27% vs 11%; relative risk = 2.45; 95% confidence interval = 1.55, 3.01). These relationships persisted after adjustment for prematurity, neonatal hospitalization, and demographic factors. It is concluded that pregnancy complications may place a woman at increased risk of postpartum depression and may have important effects on a mother's long-term perceptions of her child's vulnerability to illness.
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