Do socioeconomic and birth order gradients in child maltreatment differ by immigrant status?

Association of maternal risk factors with infant maltreatment: an administrative data cohort study

OBJECTIVE

We aimed to evaluate the risk of infant maltreatment associated with commonly used criteria for home visiting programmes: young maternal age, maternal adversity (homelessness, substance abuse, intimate partner violence), newcomer status and mental health concerns in Ontario, Canada.

DESIGN

This retrospective cohort study included infants born in hospital in Ontario from 1 April 2005 to 31 March 2017 captured in linked health administrative and demographic databases. Infants were followed from newborn hospitalisation until 1 year of age for child maltreatment captured in healthcare or death records. The association between type and number of maternal risk factors, and maltreatment, was analysed using multivariable logistic regression modelling, controlling for infant characteristics and material deprivation. Further modelling explored the association of each year of maternal age with maltreatment.

RESULTS

Of 989 586 infants, 434 (0.04%) had recorded maltreatment. Maternal age <22 years conferred higher risk of infant maltreatment (adjusted OR (aOR) 5.5, 95% CI 4.5 to 6.8) compared with age ≥22 years. Maternal mental health diagnoses (aOR 2.0, 95% CI 1.6 to 2.5) were also associated with maltreatment, while refugee status appeared protective (aOR 0.6, 95% CI 0.4 to 1.0). The odds of maltreatment increased with higher numbers of maternal risk factors. Maternal age was associated with maltreatment until age 28 years.

CONCLUSION

Infants born to young mothers are at greater risk of infant maltreatment, and this association remained until age 28 years. These findings are important for ensuring public health interventions are supporting populations experiencing structural vulnerabilities with the aim of preventing maltreatment.

Caries status of first-born child is a predictor for caries experience in younger siblings

Objectives

This study analysed if children of families in need of dental interventions can be identified by using the caries status of the first-born child as a predictor for caries in younger siblings of the same family.

Material and methods

All children aged 4 to 15 years, i.e. 13,596 children, visiting a compulsory school in the canton of Basel-Stadt, Switzerland, during the school year 2017/2018 were analysed. Total caries experience and untreated carious lesions at time of examination were recorded as well as a subset of socioeconomic factors such as gender, age, nationality, birth order and the family’s place of residence.

Results

A total of 6738 schoolchildren who had at least one sibling of school age could be included. Differences in caries experience and the presence of active carious lesions were found for age, nationality and place of residence but not for gender or birth order. Younger siblings had odds of having a history of caries 3.7 times higher (95% confidence interval: 3.0–4.4) and odds of having active carious lesions 3.5 times higher (95% confidence interval: 2.6–4.7) if the eldest child in the family already had caries.

Conclusion

Caries could be shown to be family-dependent. Younger siblings had a more than three-fold higher risk for caries if the first-born child already had carious lesions.

Clinical relevance

Based on these results, the caries status of the first-born child could be used as a potential indicator to detect vulnerable families and to initiate targeted preventive measures.