Perinatal complications and child abuse in a poverty sample.
ABSTRACT Perinatal medical illness has been associated with child maltreatment. Using a Child Protective Service (CPS) report as the defining event, this study explores to what extent perinatal morbidity is a risk factor for maltreatment.
Medical charts of 206 children ages 0-3 years were reviewed. Data regarding birth history were collected and analyzed in three groups of children: children whose medical record indicated a report to CPS based on prenatal findings (Early Maternal Inadequacy group [EMI]), children whose medical record indicated a report to CPS based only on postnatal findings (Child Maltreatment group [CM]), and a control group without CPS report (NM).
Compared to the CM and the NM groups, children in the EMI group showed significantly lower birth weight and higher neonatal morbidity as measured by Apgar scores, frequency of oxygen requirement and intubation at birth, frequency of admission to Neonatal Intensive Care unit, and frequency of neonatal medical problems. There was no significant difference between the CM and the NM groups in birth weight, gestational age, and other measures of morbidity.
The results of the study suggest that perinatal complications are associated with prenatal maltreatment. Previously reported strong associations between neonatal morbidity and child abuse are more likely a result of antecedent prenatal maternal behaviors (early maternal inadequacy). Early maternal inadequacy, a clinically and demographically distinct phenomenon, is important due to serious health, development and financial implications and deserves further exploration.
Article: The authors respondJournal of Adolescent Health 03/2002; 30(3). DOI:10.1016/S1054-139X(01)00420-7 · 2.75 Impact Factor
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ABSTRACT: Depression during pregnancy is today one of the greatest medical risks for expectant mothers and newborns. It is associated with numerous morbid conditions and with postnatal depression. Identifying depression during pregnancy is therefore a major public health concern, but screening for depression is not routinely carried out in somatic settings. We hypothesized that the presence of numerous somatic complaints contributes to the detection of an increased risk of depression during pregnancy. A cross-sectional study was conducted on 1000 consecutive pregnant women approached during OB/GYN visits at a general maternity hospital. They were asked to fill out a questionnaire, which contained the Edinburgh Postnatal Depression Scale (EPDS) and a checklist of 18 somatic complaints. The median number of somatic complaints was 5 (interquartile range 3-7). The risk of depression during the 2nd and 3rd trimesters was 18.3% (EPDS score>10.5). Logistic regression revealed that when the somatic complaints total score moved from 3 to 7, the odds of moving from not-at-risk to at-risk for antenatal depression were multiplied by 2.91. Our results call for further research exploring somatic complaints and their link to depression during pregnancy. Until more knowledge is available, we suggest considering that women with a high number of somatic complaints during pregnancy are at high risk for depression and should be referred for further diagnostic clinical assessment and care.European journal of obstetrics, gynecology, and reproductive biology 08/2013; 171(1). DOI:10.1016/j.ejogrb.2013.08.013 · 1.63 Impact Factor
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ABSTRACT: The purpose of this study is to investigate the effectiveness of a group-based family intervention program known as the Group Positive Parenting Program (Triple P), with families in Japan. Reductions in children’s behavioral problems, changes in dysfunctional parenting practices, and affects on parenting adjustment were examined. Participants of both the intervention and control groups (N = 91 and N = 24, respectively) were recruited from mothers visiting health clinics in Kawasaki City, Kanagawa. Intervention and control groups were assessed in terms of child behavior (Strength and Difficulty Questionnaire, SDQ), parenting style (Parenting Scale, PS), and parenting adjustment (Depression-Anxiety-Stress Scale, DASS; and Parenting Experience Survey, PES), both pre- and postintervention. A repeated measures multivariate analysis of variance was used to determine the intervention’s effects. The SDQ score for the conduct problems subscale indicated a significant intervention effect. In addition, the postintervention scores for all subscales of the PS, the DASS depression subscale and total scores, as well as ratings for perceived difficulty of parenting in the PES, were significantly reduced in the intervention group alone. The PES also revealed that confidence in parenting significantly increased only in the intervention group. Group Triple P is effective in decreasing child conduct problems, dysfunctional parenting practices, depression, anxiety, stress, and the perceived level of parenting difficulty, as well as in improving parenting confidence, among Japanese families.Journal of Child and Family Studies 12/2011; 24(5). DOI:10.1007/s10826-011-9448-1 · 1.42 Impact Factor