Maternal Risk Factors for Potential Maltreatment Deaths Among Healthy Singleton and Twin Infants

Abstract

Our aim was to evaluate the risk of death among healthy infants due to maltreatment, using national linked vital statistics data. The study population included all nonanomalous, full-term (≥ 37 weeks), non-low birthweight (> 2500 grams) infants born between 1995 and 2000 and their linked death certificates: 18,673,439 singleton pregnancies (36,864 deaths) and 77,800 twin pregnancies (356 pregnancies with a death). The underlying cause of death was characterized as due to maltreatment, sudden infant death syndrome (SIDS), and other causes, based on ICD-9 and ICD-10 codes, and modeled by maternal age using multinomial logistic regression; mothers aged 25 to 29 were the reference group. The highest risk for infant mortality was among the youngest mothers for maltreatment (AOR 2.45 and 1.95 for singleton mothers < 20 and aged 20 to 24, respectively; AOR 4.34 and 2.25 for twin mothers < 20 and aged 20 to 24, respectively). The risk of death overall and for each category was modeled by maternal age < 20, aged 20 to 24, and ≥ 25, with and without the father's age present on the birth certificate, with mothers ≥ 25 and father's age present as the reference group. All risks of death were significantly increased for mothers younger than age 25, with the highest risks among the youngest mothers and missing father's age. The pattern for twins was similar, with elevated risks among younger mothers with or without father's age present on the birth certificate. These results add to the body of knowledge regarding risk factors for infant mortality among healthy singletons and twins.

Fatal child maltreatment associated with multiple births in Japan: nationwide data between July 2003 and March 2011

“…This value is slightly higher than the present result, but not higher than that estimated by Tanimura et al [4], although the age distribution of the victims was very different. The difference between the present data, the data of Luke and Brown [8] and the data of Tanimura et al [4] was that the former two data sets corresponded to fatal child maltreatment, i.e., child deaths, and the latter corresponded to survivors of maltreatment admitted to the hospital. The higher proportion of twins in the data of Tanimura et al [4], however, was not rationally explained by this difference in the data.…”

“…Using the data presented by Luke and Brown [8], the percentages of total maltreatment deaths before 1 year of age among singletons and multiple births from 1995 to 2000 in the US were recalculated as 0.0232 % (=4,325/ 18,636,575) and 0.0607 % (=47/77,460), respectively, which produced an RR of 2.62 with 95 % CI 1.96-3.49 per child. This value is slightly higher than the present result, but not higher than that estimated by Tanimura et al [4], although the age distribution of the victims was very different.…”

“…Luke and Brown [8], using US vital statistics, showed an increased risk of infant maltreatment deaths among healthy, full-term infants among those born to mothers aged 24 and younger.…”

Child Maltreatment Among Singletons and Multiple Births in Japan: A Population-Based Study

“…These factors may be associated with child maltreatment (Brown et al, 1998;Chaffin et al, 1996;Dinwiddie & Bucholz, 1993;Kotch et al, 1999;Luke & Brown, 2007) and should be investigated in future studies.…”

Infant Mortality Among Singletons and Twins in Japan During 1999–2008 on the Basis of Risk Factors

“…The reduced risk of IMR in twins relative to singletons may be related to a part of the medical treatment for twin -twin transfusion syndrome now available in Japan (Imaizumi & Hayakawa, 2012). According to Luke and Brown (2007), IMRs in singletons and twins were higher in mothers aged <20 years than in those aged ≥40 years in the United States during 1995-2000. In the present study, identical results were obtained in twins, but in singletons, the opposite result was obtained.…”