Perinatal Risk and Protective Factors for Pediatric Abusive Head Trauma: A Multicenter Case-Control Study

Kelly, Patrick J.; Thompson, John M. D.; Koh, Lee Jin; Ameratunga, Shanthi; Jelleyman, Timothy; Percival, Teuila; Elder, Hinemoa; Mitchell, Edwin A.

doi:10.1016/j.jpeds.2017.04.058

Cited by 21 publications

(29 citation statements)

References 42 publications

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“…Abused children had higher rates of perinatal-related (eg, prematurity) diagnoses compared with controls, and perinatal-related conditions accounted for ∼1 in 6 previous inpatient visits among abused children. Our results are in agreement with previous findings that prematurity and low birth weight are associated with increased risk for physical abuse 10,[27][28][29][30] but that congenital anomalies (eg, spina bifida) may not be. 28 Our results support NICUs as areas at children' s hospitals that may particularly benefit from abuse prevention efforts.…”

Section: Discussionsupporting

confidence: 93%

Potential Opportunities for Prevention or Earlier Diagnosis of Child Physical Abuse in the Inpatient Setting

Puls¹,

Anderst

Bettenhausen³

et al. 2018

Hospital Pediatrics

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Infants hospitalized with perinatal-related conditions, symptoms concerning for occult AHT, and injuries are inpatient populations who may benefit from abuse prevention efforts and/or risk assessments. Head injuries and symptoms concerning for occult AHT (eg, isolated vomiting, seizures, and brief resolved unexplained events) may represent missed opportunities to diagnose AHT in the inpatient setting; however, this requires further study.

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Section: Discussionsupporting

confidence: 93%

Potential Opportunities for Prevention or Earlier Diagnosis of Child Physical Abuse in the Inpatient Setting

Puls¹,

Anderst

Bettenhausen³

et al. 2018

Hospital Pediatrics

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“…Risk factors of child maltreatment and perinatal records have been reported to be related. Kelly et al found an association between perinatal records and subsequent abusive head trauma; the risk factors of abusive head trauma were being young, single, and Maori; having shorter interpregnancy intervals, rupture of membranes for longer than 48 h, and an early gestational age at delivery; and engaging in formula feeding in the first week of life (17). Further, a large UK cohort study, the Avon Longitudinal Study of Parents and Children (ALSPAC), reported the risk factors during pregnancy associated with child maltreatment (7,18,19).…”

Section: Discussionmentioning

confidence: 99%

Perinatal Determinants of Child Maltreatment in Japan

et al. 2020

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Background: Child maltreatment induces significant health problems, both during childhood and into adulthood. To prevent child maltreatment, it is important to detect perinatal risk factors for earlier intervention. The aim of this study was to evaluate the perinatal risk factors associated with child maltreatment during pregnancy. Methods: A case-control study was conducted to compare perinatal data from the Maternal and Child Health Handbook between the case and control groups. Cases were collected from children registered in two Child Guidance Centers in Japan. The control group consisted of 3.5-year-old children in a city in Osaka Prefecture whose mothers responded to questionnaires containing information from the Maternal and Child Health Handbook. The association between perinatal factors and child maltreatment was assessed using multiple logistic regression analysis. Results: The data of 70 cases and 345 controls were collected. The following were found to be perinatal factors related to child maltreatment: teenage pregnancy (

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“…That study is described in detail elsewhere 8. Briefly, cases were admitted to Starship Children’s Hospital from 1991 to 2010 and met four criteria: (1) age <2 years; (2) intracranial injury and/or skull fracture; (3) AHT diagnosed through a rigorous multi-disciplinary process and reported to statutory authorities13; (4) born in one of nine participating maternity hospitals in the North Island of New Zealand 8. The study population included these cases and four controls for each case randomly selected from babies born on the same day in the same maternity hospital.…”

Section: Methodsmentioning

confidence: 99%

“…The study population included these cases and four controls for each case randomly selected from babies born on the same day in the same maternity hospital. In 2016, controls were checked with the Ministry of Health and statutory authorities to confirm that they did not sustain AHT up to the age of 5 years 8…”

Section: Methodsmentioning

confidence: 99%

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Do data from child protective services and the police enhance modelling of perinatal risk for paediatric abusive head trauma? A retrospective case-control study

et al. 2019

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ObjectivesFirst, to investigate whether there is a relationship between a family being known to child protective services or police at the time of birth and the risk of abusive head trauma (AHT, formerly known as shaken baby syndrome). Second, to investigate whether data from child protective services or police improve a predictive risk model derived from health records.DesignRetrospective case control study of child protective service and police records.SettingNine maternity hospitals.Participants142 consecutive cases of AHT admitted to a tertiary children’s hospital from 1991 to 2010 and born in one of the nine participating maternity hospitals. 550 controls matched by the date and hospital of birth.Outcome measureAbusive head trauma.ResultsThere is a relationship between families known to child protective services or police and the risk of AHT. Notification to child protective services: univariable OR 7.24 (95% CI 4.70 to 11.14). Involvement with youth justice: univariable OR 8.94 (95% CI 4.71 to 16.95). Police call-out for partner violence: univariable OR 3.85 (95% CI 2.51 to 5.91). Other violence offence: univariable OR 2.73 (95% CI 1.69 to 4.40). Drug offence: univariable OR 2.82 (95% CI 1.63 to 4.89). However, in multi-variable analysis with data from perinatal health records, notification to child protective services was the only one of these variables to remain in the final model (OR 4.84; 95% CI 2.61 to 8.97) and had little effect on overall predictive power. The area under the receiver operating characteristic curve was 89.5% (95% CI 86.6 to 92.5) using variables from health data alone and 90.9% (95% CI 88.0 to 93.7) when notification was added.ConclusionsFamily involvement with child protective services or police is associated with increased risk of AHT. However, accessing such data at the time of birth would add little predictive power to a risk model derived from routine health information.

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Perinatal Risk and Protective Factors for Pediatric Abusive Head Trauma: A Multicenter Case-Control Study

Cited by 21 publications

References 42 publications

Potential Opportunities for Prevention or Earlier Diagnosis of Child Physical Abuse in the Inpatient Setting

Potential Opportunities for Prevention or Earlier Diagnosis of Child Physical Abuse in the Inpatient Setting

Perinatal Determinants of Child Maltreatment in Japan

Do data from child protective services and the police enhance modelling of perinatal risk for paediatric abusive head trauma? A retrospective case-control study

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