Fujiwara Takeo, Yamaoka Yui, Morisaki Naho
Department of Social Medicine, National Research Institute for Child Health and Development.
J Epidemiol. 2016;26(1):4-13. doi: 10.2188/jea.JE20140216. Epub 2015 Dec 5.
To estimate the prevalence of shaking and smothering and to determine risk factors in a population-based sample of mothers with 4-month-old infants in Japan.
We administered a questionnaire to women who participated in a 4-month health checkup program in Aichi Prefecture, Japan (n = 6487; valid response rate, 66.8%), and assessed frequency of shaking and smothering during the past 1 month, as well as maternal, infant, and familial characteristics. Associations of shaking, smothering, and either shaking or smothering with possible risk factors were analyzed using multiple logistic regression.
Self-reported prevalence of shaking, smothering, and either shaking or smothering at least once during the past month was 3.9% (95% confidence interval [CI], 3.5%-4.4%), 2.7% (95% CI, 2.3%-3.1%), and 5.4% (95% CI, 4.9%-6.0%) respectively. Several different risk factors were found for shaking and smothering. Risk factors for either shaking or smothering were age 34 years or younger (especially 24 years or younger), age 40 years or older, full-time working, later attendance at 4-months health checkup, primiparity, living in a detached house, living on the 2nd floor or higher (especially on the 10th floor or higher), economic adversity, perceived excessive crying, and postpartum depression. Protective factors against infant abuse were living in a four-room house and having a larger number of people to consult with.
Self-reported prevalences of shaking and smothering among mothers in Japan were similar to prevalences reported in western countries. These finding may be useful for identifying mothers at increased risk of shaking and smothering their infants.
评估摇晃和窒息行为的发生率，并确定日本4个月大婴儿母亲的基于人群样本中的风险因素。
我们对参与日本爱知县4个月健康检查项目的女性进行了问卷调查（n = 6487；有效回复率为66.8%），并评估了过去1个月内摇晃和窒息行为的频率，以及母亲、婴儿和家庭特征。使用多元逻辑回归分析摇晃、窒息以及摇晃或窒息与可能风险因素之间的关联。
自我报告的过去1个月内至少有一次摇晃、窒息以及摇晃或窒息行为的发生率分别为3.9%（95%置信区间[CI]，3.5%-4.4%）、2.7%（95%CI，2.3%-3.1%）和5.4%（95%CI，4.9%-6.0%）。发现了几种不同的摇晃和窒息风险因素。摇晃或窒息的风险因素包括34岁及以下（尤其是24岁及以下）、40岁及以上、全职工作、较晚参加4个月健康检查、初产、居住在独立房屋、居住在二楼或更高楼层（尤其是十楼或更高楼层）、经济困难、感觉婴儿过度哭闹以及产后抑郁。预防虐待婴儿的保护因素是居住在四居室房屋且有更多可咨询的人。
日本母亲自我报告的摇晃和窒息行为发生率与西方国家报告的发生率相似。这些发现可能有助于识别有较高摇晃和窒息婴儿风险的母亲。
