Prematurity and neonatal comorbidities as risk factors for nonaccidental trauma

Doud, Andrea N.; Lawrence, Kendall M.; Goodpasture, Meggan; Zeller, Kristen A.

doi:10.1016/j.jpedsurg.2015.03.029

Cited by 7 publications

(7 citation statements)

References 19 publications

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“…Publicly insured newborns who were exposed to drugs (aRR 5.05; 95% CI: 3.54-7.21) and publicly insured preterm and LBW newborns from nonrural counties (aRR 3.27; 95% CI: 2.77-3.85) were the second and third highest-risk typologies, respectively. Prematurity and LBW have consistently been independently associated with maltreatment in general 23,[32][33][34] and physical abuse specifically, 13,24,33,35 but their prevalence among infants who are abused has not been adequately reported. We found that 1 in 5 young infants who were abused had a history of prematurity and LBW.…”

Section: Identification Of the Newborns At Highest Risk By Using Cart Modelingmentioning

confidence: 99%

“…Prematurity and LBW newborns were at an approximately twofold increased risk for abuse during early infancy, which is similar to previous findings. 24,35 When preterm and LBW newborns were also poor (ie, they had public insurance) and from rural counties, their risk for abuse hospitalization was ∼10-fold higher than all other newborns and threefold higher than similar preterm and LBW infants who were poor and from nonrural counties. However, rural residence was not independently associated with abuse hospitalization in our sample, and previous studies have been inconsistent in how physical abuse 36,37 and maltreatment in general 38,39 may vary across the urban-rural spectrum.…”

Section: Identification Of the Newborns At Highest Risk By Using Cart Modelingmentioning

confidence: 99%

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Newborn Risk Factors for Subsequent Physical Abuse Hospitalizations

Puls¹,

Anderst

Bettenhausen³

et al. 2019

Pediatrics

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OBJECTIVES:To describe the prevalence of risk factors for abuse and newborns' risks for physical abuse hospitalizations during early infancy. METHODS:We created a nationally representative US birth cohort using the 2013 and 2014 Nationwide Readmissions Databases. Newborns were characterized by demographics, prematurity or low birth weight (LBW), intrauterine drug exposure, and medical complexity (including birth defects). Newborns were tracked for 6 months from their birth hospitalization, and subsequent abuse hospitalizations were identified by using International Classification of Diseases, Ninth Revision codes. We calculated adjusted relative risks (aRRs) with multiple logistic regression, and we used classification and regression trees to identify newborns with the greatest risk for abuse on the basis of combinations of multiple risk factors.RESULTS: There were 3 740 582 newborns in the cohort. Among them, 1247 (0.03%) were subsequently hospitalized for abuse within 6 months. Among infants who were abused, 20.4% were premature or LBW, and 4.1% were drug exposed. Premature or LBW newborns (aRR 2.16 [95% confidence interval (CI): 1.87-2.49]) and newborns who were drug exposed (aRR 2.86 [95% CI: 2.15-3.80]) were independently at an increased risk for an abuse hospitalization, but newborns with medical complexity or noncardiac birth defects were not. Publicly insured preterm or LBW newborns from rural counties had the greatest risk for abuse hospitalizations (aRR 9.54 [95% CI: 6.88-13.23]). Publicly insured newborns who were also preterm, LBW, or drug exposed constituted 5.2% of all newborns, yet they constituted 18.5% of all infants who were abused.CONCLUSIONS: Preterm or LBW newborns and newborns who were drug exposed, particularly those with public insurance and residing in rural counties, were at the highest risk for abuse hospitalizations. Effective prevention directed at these highest-risk newborns may prevent a disproportionate amount of abuse.WHAT'S KNOWN ON THIS SUBJECT: Current physical abuse prevention strategies have had inconsistent and marginal effectiveness. A better stratification of newborn infants' risk for physical abuse may prove valuable in informing the allocation of preventive services and improving their effectiveness.WHAT THIS STUDY ADDS: Using a nationally representative birth cohort, we report on risk factors for physical abuse that can be readily ascertained at birth. Five percent of newborns were identified as accounting for 1 in 5 infants who are abused and should be targets for secondary prevention.

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Section: Identification Of the Newborns At Highest Risk By Using Cart Modelingmentioning

confidence: 99%

Section: Identification Of the Newborns At Highest Risk By Using Cart Modelingmentioning

confidence: 99%

Newborn Risk Factors for Subsequent Physical Abuse Hospitalizations

Puls¹,

Anderst

Bettenhausen³

et al. 2019

Pediatrics

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“…In addition to the maternal risks described above, many SENs have particularly intense needs and behaviors that can increase family stress and, consequently, risk of child maltreatment (Dunn et al, 2002). SENs are more likely than non-SENs to be born premature and to have low birthweight, two risk factors for infant maltreatment (Doud et al, 2015; Wu et al, 2004). They may also have symptoms associated with neonatal abstinence syndrome, such as irritability, inconsolable crying, vomiting, diarrhea, and seizures, which may increase caregiving stress in families (Patrick et al, 2012).…”

Section: Multiple Interacting Pathways To Child Maltreatment For Families With Sensmentioning

confidence: 99%

“…Substance-exposed newborns (SENs) are a population at particularly high risk of child maltreatment, out-of-home placement, and negative developmental outcomes. Multiple studies have documented compromised parenting and increased risk of child abuse and neglect among parents who misuse substances (Doud, Lawrence, Goodpasture, & Zeller, 2015; Douglas, 2013; Dubowitz et al, 2011). Additionally, rates of placement of SENs into foster care are nearly 11 times higher than non-SENs (Prindle, Hammond, & Putnam-Hornstein, 2018) and have been increasing nationally since 2010 (Lynch, Sherman, Snyder, & Mattson, 2018).…”

mentioning

confidence: 99%

Systematic Review of Community- and Home-Based Interventions to Support Parenting and Reduce Risk of Child Maltreatment Among Families With Substance-Exposed Newborns

et al. 2019

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Substance-exposed newborns (SENs) are at increased risk of child maltreatment, out-of-home placement, and poor health and developmental outcomes. The purpose of this systematic review is to synthesize existing research on community- and home-based interventions designed to improve parenting and reduce risk of maltreatment for families with SENs, applying a program logic framework. The review includes studies that used preexperimental, quasi-experimental, and experimental designs. Twelve interventions were identified. Of the nine studies that used more rigorous experimental or quasi-experimental designs, five showed positive effects on at least one parenting or child maltreatment outcome, although some studies showed high risk of bias. Full coherence among the intended participants, theory of change, and program components was observed for only two interventions. The findings suggest a need for more rigorous research to develop and test interventions that are grounded in theory and prior research and that address the unique needs of families with SENs.

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“…EPT children are at increased risk for delayed or disordered language (2,7,9,18,21,22). Known sequelae of prematurity include decreased college attendance, decreased professional attainments, increased risk for abuse and nonaccidental trauma, decreased likelihood of developing significant romantic partnerships in adulthood, decreased likelihood of having their own children in adulthood, and decreased quality of life (23)(24)(25)(26)(27). Language is important for general cognitive and scholastic development and establishment of relationships with both caregivers and peers (28).…”

Section: Introductionmentioning

confidence: 99%

Extracallosal Structural Connectivity Is Positively Associated With Language Performance in Well-Performing Children Born Extremely Preterm

et al. 2022

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Children born extremely preterm (<28 weeks gestation) are at risk for language delay or disorders. Decreased structural connectivity in preterm children has been associated with poor language outcome. Previously, we used multimodal imaging techniques to demonstrate that increased functional connectivity during a stories listening task was positively associated with language scores for preterm children. This functional connectivity was supported by extracallosal structural hyperconnectivity when compared to term-born children. Here, we attempt to validate this finding in a distinct cohort of well-performing extremely preterm children (EPT, n = 16) vs. term comparisons (TC, n = 28) and also compare this to structural connectivity in a group of extremely preterm children with a history of language delay or disorder (EPT-HLD, n = 8). All participants are 4–6 years of age. We perform q-space diffeomorphic reconstruction and functionally-constrained structural connectometry (based on fMRI activation), including a novel extension enabling between-groups comparisons with non-parametric ANOVA. There were no significant differences between groups in age, sex, race, ethnicity, parental education, family income, or language scores. For EPT, tracks positively associated with language scores included the bilateral posterior inferior fronto-occipital fasciculi and bilateral cerebellar peduncles and additional cerebellar white matter. Quantitative anisotropy in these pathways accounted for 55% of the variance in standardized language scores for the EPT group specifically. Future work will expand this cohort and follow longitudinally to investigate the impact of environmental factors on developing language networks and resiliency in the preterm brain.

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Prematurity and neonatal comorbidities as risk factors for nonaccidental trauma

Cited by 7 publications

References 19 publications

Newborn Risk Factors for Subsequent Physical Abuse Hospitalizations

Newborn Risk Factors for Subsequent Physical Abuse Hospitalizations

Systematic Review of Community- and Home-Based Interventions to Support Parenting and Reduce Risk of Child Maltreatment Among Families With Substance-Exposed Newborns

Extracallosal Structural Connectivity Is Positively Associated With Language Performance in Well-Performing Children Born Extremely Preterm

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