Population, Policy and Practice Research and Teaching Department, University College London Great Ormond Street Institute of Child Health, London, United Kingdom.
Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia; Australian Centre for Child Protection, University of South Australia, Adelaide, South Australia, Australia.
Child Abuse Negl. 2020 Nov;109:104760. doi: 10.1016/j.chiabu.2020.104760. Epub 2020 Oct 11.
The risk of entry to state care during infancy is increasing, both here in England and abroad, with most entering within a week of birth ('newborns'). However, little is known about these infants or of their pathways through care over early childhood.
To characterize infant entries to care in England.
All children in England who first entered care during infancy, between April 2006 and March 2014 (n = 42,000).
We compared sociodemographic and care characteristics for infants entering care over the study period by age at first entry (newborn: <1wks, older infant 1-51wks). Among those who entered before April 2010, we further characterized care over follow-up (i.e. 4 years from first entry) and employed latent class analysis to uncover any common pathways through care.
Almost 40 % of infants first entered care as a newborn. Most infants first entered care under s 20 arrangements (i.e. out-of-court, 60 % of newborns vs 47 % of older infants). Among infants entering before April 2010, most were adopted over follow-up (60 % vs 37 %), though many were restored to parental care (20 % vs 32 %) or exited care to live with extended family (13 % vs 19 %). One in six infants (17.7 %) had particularly unstable care trajectories over early childhood, typified by three or more placements or failed reunification.
Evidence-based strengthening of pre-birth social work support is needed to improve preventive interventions before birth, to more effectively target infant placement into care. Linkages between child protection records and information on parents are needed to inform preventive strategies.
在婴儿期进入国家照护的风险正在增加，无论是在英国还是在国外，大多数人都是在出生后一周内进入（“新生儿”）。然而，人们对这些婴儿或他们在幼儿期通过护理途径的了解甚少。
描述英国婴儿进入护理的情况。
2006 年 4 月至 2014 年 3 月期间在英国首次进入婴儿期护理的所有儿童（n=42000）。
我们比较了研究期间按首次进入护理的年龄（新生儿：<1 周，较大婴儿 1-51 周）分组的婴儿的社会人口统计学和护理特征。在 2010 年 4 月之前进入护理的婴儿中，我们进一步描述了随访期间（即首次进入护理后 4 年）的护理情况，并采用潜在类别分析揭示了任何常见的护理途径。
近 40%的婴儿首次进入护理是作为新生儿。大多数婴儿首次进入护理是通过第 20 条安排（即庭外，60%的新生儿和 47%的较大婴儿）。在 2010 年 4 月之前进入护理的婴儿中，大多数在随访期间被收养（60%比 37%），尽管许多婴儿被恢复到父母的照顾（20%比 32%）或离开护理与大家庭一起生活（13%比 19%）。六分之一的婴儿（17.7%）在幼儿期的护理轨迹特别不稳定，其特征是有三次或更多次安置或未能实现家庭团聚。
需要加强产前社会工作支持的循证依据，以改善出生前的预防干预措施，更有效地将婴儿安置在护理中。需要在儿童保护记录和父母信息之间建立联系，以制定预防策略。
