Citation

Tandon M, Jonson-Reid M, Constantino J. J. Am. Acad. Child Adolesc. Psychiatry 2022; ePub(ePub): ePub.

Copyright

(Copyright © 2022, American Academy of Child Adolescent Psychiatry, Publisher Lippincott Williams and Wilkins)

DOI

10.1016/j.jaac.2022.05.008

PMID

35690303

Abstract

This is a communication of preliminary data as a matter of priority in relation to Clinical Trials protocol ID 2018110118; NCT 04438161. This protocol represents, to our knowledge, a first-ever attempt to convert an epidemiologic discovery on risk for child maltreatment (CM) into a readily-deployable modification of obstetrical practice designed to offset risk for CM and its psychiatric sequelae. Prior to and during the COVID-19 pandemic CM has incurred a burden of epidemic proportions to U.S. children, confirmed incidents occurring on the order of 12 percent of the population. Wu et al.and Putnam-Hornstein and Needell previously established that profiles of risk ascertained exclusively from birth records identified specific groups of newborns at highly-elevated risk for official-report child maltreatment (CM). For example, infants with the joint characteristics of low birth weight, more than 2 siblings, and maternal characteristics of being unmarried, on Medicaid, and smoking during pregnancy (ascertained separately), were found to have a 7-fold risk for maltreatment compared to the population average. Putnam-Hornstein and Needell showed that newborns with three or more birth-records risk factors (including any of the above and/or delayed prenatal care, less than high school education and/or maternal age less than 24 years) comprised 15% of an epidemiologic birth cohort but accounted for over half of all the children in the cohort who experienced substantiated official-report maltreatment by the age of 5 years. This study explored whether prospective implementation of birth records screening in an urban obstetrical service recapitulated the association with CM observed in an epidemiologic context, and whether families in higher echelons of risk (ascertained in this manner through birth record information) could be prospectively engaged in supportive interventions of demonstrated effect in reducing the occurrence of CM. This work follows on promising efforts elsewhere to utilize birth records information to prioritize support services for young families, though such innovations have yet to be systematically incorporated into obstetrical or newborn medical services of US health systems.

Language: en