Hammond Ivy, Eastman Andrea Lane, Leventhal John M, Putnam-Hornstein Emily
Children's Data Network, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA 90089, USA.
School of Medicine, Yale University, New Haven, CT 06510, USA.
Int J Environ Res Public Health. 2017 Oct 30;14(11):1320. doi: 10.3390/ijerph14111320.
. Existing literature has documented a strong relationship between parental mental illness and child maltreatment, but little is known about the prevalence of mental illness among childbearing women. In the present study, linked administrative records were used to identify the prevalence of maternal mental health (MH) disorders documented at birth and determine the associated likelihood of maltreatment reports during infancy. . Vital records for California's 2006 birth cohort were linked to hospital discharge and Child Protective Services (CPS) records. The International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) billing codes from the mother's delivery hospitalization were used to determine diagnosed maternal MH disorders for 551,232 infants born in 2006, and reports of alleged maltreatment were documented from CPS records. Vital birth records were used to control for sociodemographic factors. Finally, the associated risk of reported maltreatment during the first year of life was examined using generalized linear models. . Among infants in this statewide birth cohort, 2.8% were born to a mother with a documented MH disorder, of which 41.3% had documented maternal substance abuse issues versus less than 0.5% of infants born to mothers without a diagnosed MH disorder. Further, 34.6% of infants born to mothers with a MH disorder were reported to CPS within one year, and a majority of those reports were made within the first month of life (77.2%). In contrast, among children born to mothers without a MH disorder, 4.4% were reported to CPS during infancy. After controlling for sociodemographic factors, the rate of CPS reports during infancy for infants born to mothers with a MH disorder but no substance use disorder was 2.6 times that of infants born to mothers without a MH disorder (95% CI = 2.47, 2.73). Among infants born to mothers with MH and substance use disorders, the rate of CPS reports during infancy was 5.69 times that of infants born to mothers without a MH disorder (95% CI = 5.51, 5.87). . Administrative records provide a method for identifying infants born to mothers with MH disorders, enabling researchers to track rates over time and generate population-level data to inform policy development and improve service delivery.
现有文献记载了父母的精神疾病与虐待儿童之间存在密切关系，但对于育龄妇女中精神疾病的患病率却知之甚少。在本研究中，通过关联行政记录来确定出生时记录的母亲心理健康（MH）障碍的患病率，并确定婴儿期虐待报告的相关可能性。加利福尼亚州2006年出生队列的生命记录与医院出院记录和儿童保护服务（CPS）记录相关联。使用母亲分娩住院时的《国际疾病分类，第九次修订本，临床修订版》（ICD-9-CM）计费代码来确定2006年出生的551,232名婴儿的母亲被诊断出的MH障碍，并从CPS记录中记录涉嫌虐待的报告。使用出生生命记录来控制社会人口统计学因素。最后，使用广义线性模型检查生命第一年报告的虐待相关风险。在这个全州范围的出生队列中的婴儿中，2.8%的婴儿母亲有记录在案的MH障碍，其中41.3%的母亲有记录在案的药物滥用问题，而没有被诊断出MH障碍的母亲所生婴儿的这一比例不到0.5%。此外，有MH障碍的母亲所生的婴儿中，34.6%在一年内被报告给CPS，其中大多数报告是在生命的第一个月内（77.2%）。相比之下，没有MH障碍的母亲所生的儿童中，4.4%在婴儿期被报告给CPS。在控制了社会人口统计学因素后，有MH障碍但没有药物使用障碍的母亲所生婴儿在婴儿期被CPS报告的比率是没有MH障碍的母亲所生婴儿的2.6倍（95%置信区间 = 2.47, 2.73）。在有MH和药物使用障碍的母亲所生的婴儿中，婴儿期被CPS报告的比率是没有MH障碍的母亲所生婴儿的5.69倍（95%置信区间 = 5.51, 5.87）。行政记录提供了一种识别有MH障碍母亲所生婴儿的方法，使研究人员能够跟踪不同时间的比率，并生成人群水平的数据，为政策制定提供信息并改善服务提供。
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