Predictors of infant foster care in cases of maternal psychiatric disorders

Abstract

This study highlights the existence of factors other than maternal pathology that lead to decisions to separate mother and child for the child's protection in a population of mentally ill mothers jointly hospitalized with the baby in the postpartum period.

A systematic review of research on psychiatric mother-baby units

“…In terms of the same datasets, Salmon and colleagues draw on the same UK Marcé database information Salmon et al 2004), and Howard and colleagues draw on a similar dataset to Salmon and colleagues but from slightly different Marcé entries (Howard et al 2003;Howard et al 2004). In France, Glangeaud-Freudenthal and colleagues draw on different samples but there was however some overlap of data from 13 French MBUs from the Marcé database, which was justified by the aims of the studies (Glangeaud-Freudenthal et al 2013;Glangeaud-Freudenthal et al 2011;Sutter-Dallay et al 2015). The data published in 2013 was added to the data from France published in 2011 (2001-2007; n=814), and the data from Belgium for the same period (2001-2007; n=1018) to allow more diversity in child status to study separation status at discharge from MBUs.…”

“…The remainder of the sources focused on multiple MBUs, with Howard et al (2004) focusing on 18 MBUs in the UK, Glangeaud-Freudenthal et al (2013) focusing on 13 in France and 3 in Belgium, GlangeaudFreudenthal et al (2011) andSutter-Dallay et al (2015) focusing on 13 in France, Elkin et al (2009) focusing on 12 in England, Glangeaud-Freudenthal and The MBU-SMF Working Group (2004) focusing on 11 in France and Belgium, Salmon et al (2003Salmon et al ( , 2004 and Abel et al (2005) focusing on eight MBUs and three facilities in the UK, Buist et al (2004) focusing on four in Australia, Vliegen et al (2010;2013) focusing on two in Belgium, and the remainder focusing on an unspecified multiple number in the UK (Howard, Shah, Salmon, and Appleby 2003) and Australia (Milgrom and Beatrice 2003).…”

“…Maternal mean age ranged from 24.25 years (Chandra et al 2015) to 33.5 years (Christl et al 2015), and infant mean age at time of admission ranged from 9.6 weeks (Glangeaud-Freudenthal et al 2013;GlangeaudFreudenthal et al 2011) to 7.82 months (Yelland et al 2015). Mean length of stay ranged from 6.93 days in a study in the US (Meltzer-Brody et al 2014) to 11.6 weeks in a study in Israel (Maizel et al 2005).…”

“…Two large studies of over 1,000 mother/child pairings have been conducted (Glangeaud-Freudenthal et al 2013;Howard et al 2003), as well as a number of smaller studies. Glangeaud-Freudenthal et al's (2013) prospective longitudinal study of 1,018 women in France and Belgium found that most children were discharged with their mothers, but that 151 (14.8%) were separated at discharge.…”

“…Of those separated, 41% of children were placed in foster families, 41% in institutions, 13% with family members (3% with fathers), and 1% stayed at the MBU for more than a month after the mother was discharged. Glangeaud-Freudenthal et al (2013) argue that there were a number of risk factors for separation: babies with medical complications, type of psychiatric disorder for mothers, type of psychiatric disorder for fathers, mothers' lack of good social relationships with others, mothers receiving disability benefits, and low socio-economic class. The importance of large sample sizes using regression analysis of statistically independent risk factors such as neo-natal medical complications, maternal and paternal psychiatric disorders, maternal relationships with others, maternal disability benefits, and social class, is evident in Glangeaud-Freudenthal et al (2013); and these authors argue that the larger sample results confirm studies that use univariate analysis of small samples.…”