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识别有心理社会问题的孕妇中预测儿童虐待的风险因素和预防因素。

Identification of risk- and preventive factors predicting child maltreatment in pregnant women with psychosocial problems.

作者信息

Ogawa Michi, Hashimoto Tasuku, Tanaka Mami, Ishii Hiroki, Seki Ryota, Sato Aiko, Kimura Atsushi, Okayama Jun, Endo Mamiko, Saito Naoki, Iyo Masaomi

机构信息

Department of Psychiatry, Graduate School of Medicine, Chiba University, Chiba, Japan.

Department of Psychiatry, Sodegaura-Satsukidai Hospital, Chiba, Japan.

出版信息

Front Psychiatry. 2025 May 21;16:1552740. doi: 10.3389/fpsyt.2025.1552740. eCollection 2025.

Abstract

INTRODUCTION

Pregnant women with psychosocial problems experience various parenting struggles, which, in the absence of adequate social support, can lead to child maltreatment. This study aimed to identify risk- and preventive factors for child maltreatment among pregnant women with psychosocial problems to facilitate the appropriate allocation of social support.

METHODS

This retrospective cohort study analyzed electronic medical records of all consecutive pregnant women with psychosocial difficulties who visited and delivered at Chiba University Hospital, and were registered with the hospital's child protection team between April 2016 and March 2019. The primary objective was to identify risk- and preventive factors associated with child maltreatment, defined as cases requiring intervention by a child guidance center. Multiple logistic regression analysis was performed to identify the risk factors and preventive factors influencing child maltreatment within the first month postpartum.

RESULTS

A total of 253 pregnant women were included in the analysis, of whom 54 were reported for child maltreatment. Maternal grandmother's support (OR: 7.85, 95%CI [3.47-17.77]) and other family members' support (OR: 3.57, 95%CI [1.51-8.41]) were identified as preventive factors. Maternal mental illness (OR: 0.40, 95%CI [0.18-0.89]) was identified as a risk factor. Additionally, the higher the mother's age (OR: 1.08, 95%CI [1.02-1.14]), the lower the incidence of child maltreatment, indicating that adolescent pregnancy is also a risk factor.

CONCLUSIONS

Family support, particularly from the maternal grandmother, plays a crucial role in enhancing parenting skills of women with psychosocial difficulties. Assessing these factors and integrating them into public support initiatives could contribute to the prevention of child maltreatment.

摘要

引言

有心理社会问题的孕妇在育儿方面面临各种困难,在缺乏足够社会支持的情况下,可能导致虐待儿童行为。本研究旨在确定有心理社会问题的孕妇中虐待儿童的风险因素和预防因素,以便于合理分配社会支持。

方法

这项回顾性队列研究分析了2016年4月至2019年3月期间在千叶大学医院就诊并分娩、且在医院儿童保护团队登记的所有连续有心理社会困难的孕妇的电子病历。主要目的是确定与虐待儿童相关的风险因素和预防因素,虐待儿童定义为需要儿童指导中心干预的案例。进行多因素逻辑回归分析以确定产后第一个月内影响虐待儿童的风险因素和预防因素。

结果

共有253名孕妇纳入分析,其中54人被报告存在虐待儿童行为。外祖母的支持(比值比:7.85,95%置信区间[3.47 - 17.77])和其他家庭成员的支持(比值比:3.57,95%置信区间[1.51 - 8.41])被确定为预防因素。母亲患有精神疾病(比值比:0.40,95%置信区间[0.18 - 0.89])被确定为风险因素。此外,母亲年龄越大(比值比:1.08,95%置信区间[1.02 - 1.14]),虐待儿童的发生率越低,这表明青少年怀孕也是一个风险因素。

结论

家庭支持,尤其是外祖母的支持,在提高有心理社会困难妇女的育儿技能方面起着关键作用。评估这些因素并将其纳入公共支持举措有助于预防虐待儿童行为。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ec8/12133810/92d18f15aad6/fpsyt-16-1552740-g001.jpg

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