Jaudes P K, Ekwo E, Van Voorhis J
Department of Pediatrics, La Rabida Children's Hospital, Chicago, IL 60649, USA.
Child Abuse Negl. 1995 Sep;19(9):1065-75. doi: 10.1016/0145-2134(95)00068-j.
To show that children born to mothers who used drugs during pregnancy were at a higher risk of subsequent abuse or neglect than were children from the general population.
This is a retrospective-prospective study of abuse experiences of children born at an urban medical center between January 1985 and December 1990 to women who used illicit drugs during pregnancy. Children exposed in-utero to drugs were identified using results of toxicology screens from birth and maternal records. Evidence of abuse was obtained from the State Central Registry of Abuse and Neglect. The registry contained information on all reported abuses or neglects, the types, findings, and outcomes of the investigations of reported cases. The outcome measure was whether the children had been abused or not during the study period.
One hundred and fifty-five (30.2%) of the 513 children exposed in-utero to drugs were reported as abused or neglected and 102 (19.9%) had substantiated reports giving a rate of 84 abuse and neglect cases per 1,000 years of exposure. The yearly substantiated abuse rates varied, the lowest being 30 cases per 1,000 years of exposure in 1986 and the highest 107 cases per 1,000 in 1987. This rate was two to three times that of children living in the same geographic area in the south side of Chicago. Neglect was reported in 72.6% of cases, with the toddlers being the most vulnerable to abuse and neglect. Natural parents were responsible for maltreatment 88% of the time. On logistic regression analysis, the risk of abuse of children increased 1.56-fold (Confidence Interval = 1.25-2.01) that of nonabusing parents among women who had completed high school education or had some college education and 1.80-fold among women with previous planned abortion, after controlling for confounding variables. Other sociodemographic variables of the child or mother did not significantly increase the odds of abuse.
Infants exposed in-utero to drugs have a higher than expected risk of subsequent abuse compared to children in the general population.
证明孕期使用毒品的母亲所生子女，相比普通人群中的儿童，遭受后续虐待或忽视的风险更高。
这是一项回顾性前瞻性研究，研究对象为1985年1月至1990年12月在一家城市医疗中心出生、其母亲在孕期使用非法药物的儿童的受虐经历。通过出生时的毒理学筛查结果和母亲记录来确定子宫内接触毒品的儿童。虐待证据来自州中央虐待与忽视登记处。该登记处包含所有报告的虐待或忽视事件的信息、报告案件调查的类型、结果和结局。结局指标是研究期间儿童是否遭受过虐待。
513名子宫内接触毒品的儿童中，有155名（30.2%）被报告遭受虐待或忽视，102名（19.9%）有确凿报告，即每1000年接触期有84起虐待和忽视案件。每年的确凿虐待率各不相同，1986年最低为每1000年接触期30起案件，1987年最高为每1000年107起案件。这一比率是芝加哥南区同一地理区域儿童的两到三倍。72.6%的案件报告有忽视情况，学步儿童最易遭受虐待和忽视。88%的虐待事件是亲生父母所为。经逻辑回归分析，在控制混杂变量后，完成高中学业或接受过一些大学教育的女性中，其子女遭受虐待的风险比未虐待儿童的父母高1.56倍（置信区间=1.25-2.01），有过计划外堕胎史的女性中这一风险高1.80倍。儿童或母亲的其他社会人口统计学变量并未显著增加虐待几率。
与普通人群中的儿童相比，子宫内接触毒品的婴儿遭受后续虐待的风险高于预期。
