Risk factors for long-bone fractures in children up to 5 years of age: a nested case–control study

Abstract

AimTo investigate risk factors for first long-bone fractures in children up to 5 years old in order to provide evidence about which families could benefit from injury prevention interventions.MethodsPopulation-based matched nested case–control study using The Health Improvement Network, a UK primary care research database, 1988–2004.Maternal, household and child risk factors for injury were assessed among 2456 children with long-bone fractures (cases). 23 661controls were matched to cases on general practice. Adjusted ORs and 95% CIs were estimated using conditional logistic regression.ResultsFractures of long-bones were independently associated with younger maternal age and higher birth order, with children who were the fourth-born in the family, or later, having a threefold greater odds of fracture compared to first-born children (adjusted OR 3.12, 95% CI 2.08 to 4.68). Children over the age of 1 year had a fourfold (13–24 months, adjusted OR 4.09 95% CI 3.51 to 4.76) to fivefold (37+ months, adjusted OR 4.88 95% CI 4.21 to 5.66) increase in the odds of a long-bone fracture compared to children aged 0–12 months. Children in families with a history of maternal alcohol misuse had a raised odds of long-bone fracture (adjusted OR 2.33, 95% CI 1.13 to 4.82) compared to those with no documented history.ConclusionsRisk factors for long-bone fractures in children less than 5 years old included age above 1 year, increasing birth order, younger maternal age and maternal alcohol misuse. These risk factors should be used to prioritise families and communities for injury prevention interventions.

Association between maternal smoking during pregnancy and risk of bone fractures in offspring: a systematic review and meta-analysis

“…2) Unbiased and larger epidemiological studies are required to confirm the factors associated with bone fracture occurrence in children and youth. Studies of the etiology of bone fractures suggest that some characteristics of children [3][4][5][6][7][8][9][10] and parents [11][12][13][14][15] may be associated with an increased risk of bone fractures in children and youth.…”

Parental alcohol intoxication and adverse health outcomes among offspring. A 4-year follow up HUNT study among 2399 Norwegian adolescents

“…Moreover, there is some evidence that children with parents diagnosed with alcohol disorders experience adverse health outcomes, both physically and mentally ( Christensen and Bilenberg, 2000 , Johnson and Leff, 1999 , Christoffersen and Soothill, 2003 , Hussong, 2008 , Hussong, 2010 , Jaaskelainen, 2016 ). Children within such a context are also at higher risk for injuries and accidents that may lead to hospitalisation ( Raitasalo, 2015 , Orton, 2012 , Baker, 2015 , Winqvist, 2007 ).…”

The Association Between Adverse Child Health, Psychological, Educational and Social Outcomes, and Nondependent Parental Substance: A Rapid Evidence Assessment

“…Potential Impact Upon Children Early childhood (0-7 years) Greater likelihood of being involved in an accident, self-poisoning incident, and sustaining an injury (Baker et al, 2015;Tyrrell et al, 2012). Requirement for medical attention and admittance to hospital (Raitasalo et al, 2015) .…”