Isumi Aya, Takahashi Kunihiko, Fujiwara Takeo
Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), Tokyo 113-8519, Japan.
Japan Society for the Promotion of Science, Tokyo 102-0083, Japan.
Int J Environ Res Public Health. 2021 Mar 3;18(5):2505. doi: 10.3390/ijerph18052505.
Identifying risk factors from pregnancy is essential for preventing child maltreatment. However, few studies have explored prenatal risk factors assessed at pregnancy registration. This study aimed to identify prenatal risk factors for child maltreatment during the first three years of life using population-level survey data from pregnancy notification forms. This prospective cohort study targeted all mothers and their infants enrolled for a 3- to 4-month-old health check between October 2013 and February 2014 in five municipalities in Aichi Prefecture, Japan, and followed them until the child turned 3 years old. Administrative records of registration with Regional Councils for Children Requiring Care (RCCRC), which is suggestive of child maltreatment cases, were linked with survey data from pregnancy notification forms registered at municipalities ( = 893). Exact logistic regression was used for analysis. A total of 11 children (1.2%) were registered with RCCRC by 3 years of age. Unmarried marital status, history of artificial abortion, and smoking during pregnancy were significantly associated with child maltreatment. Prenatal risk scores calculated as the sum of these prenatal risk factors, ranging from 0 to 7, showed high predictive power (area under receiver operating characteristic curve 0.805; 95% confidence interval (CI), 0.660-0.950) at a cut-off score of 2 (sensitivity = 72.7%, specificity = 83.2%). These findings suggest that variables from pregnancy notification forms may be predictors of the risk for child maltreatment by the age of three.
识别孕期的风险因素对于预防儿童虐待至关重要。然而,很少有研究探讨在孕期登记时评估的产前风险因素。本研究旨在利用孕期通知表中的人群水平调查数据,识别儿童出生后前三年遭受虐待的产前风险因素。这项前瞻性队列研究针对2013年10月至2014年2月期间在日本爱知县五个市参加3至4个月健康检查的所有母亲及其婴儿,并对他们进行跟踪,直至孩子满3岁。与儿童虐待案件相关的需要照顾儿童区域委员会(RCCRC)的行政登记记录,与各市登记的孕期通知表调查数据相关联(n = 893)。采用精确逻辑回归进行分析。到3岁时,共有11名儿童(1.2%)在RCCRC登记。未婚婚姻状况、人工流产史和孕期吸烟与儿童虐待显著相关。这些产前风险因素的总和计算得出的产前风险评分范围为0至7,在临界值为2时显示出较高的预测能力(受试者操作特征曲线下面积为0.805;95%置信区间(CI),0.660 - 0.950)(敏感性 = 72.7%,特异性 = 83.2%)。这些发现表明,孕期通知表中的变量可能是三岁前儿童遭受虐待风险的预测指标。