Estimating the risk of child maltreatment by age two among children born to mothers with a prior history of IPV

Monday, 18 August 2014
Exhibit hall (Dena'ina Center)
Jared W Parrish, MS , University of North Carolina at Chapel Hill, Chapel Hill, NC
Meghan Shanahan, PhD , University of North Carolina at Chapel Hill, Chapel Hill, NC
Kathy Perham-Hester, MS , Alaska Division of Public Health, Anchorage, AK
INTRODUCTION: Children living in homes with intimate partner violence (IPV) have an increased risk of child abuse; the nature of this association remains ambiguous.  While literature on the co-occurrence has been documented, the risk of child maltreatment among children born to mothers with a prior history of IPV is unknown. This study describes a retrospective cohort study conducted in Alaska to understand any potential etiologic link.

METHODS: Since 1990 the Alaska Division of Public Health has surveyed approximately 17% of all birthmothers each year using the Pregnancy Risk Assessment Monitoring Survey (PRAMS). The 2009-10 PRAMS respondents (n = 2,393) were linked to child protection services (CPS) reports occurring between 2009-2012, to examine the risk of child maltreatment by age two among children born to mothers with a prior history of IPV.  Unadjusted incidence odds ratios (IOR) and 95% confidence intervals were calculated using a median unbiased approach to account for small numbers and logistic regression was used to calculate adjusted IOR to approximate the total effects incidence risk ratio. 

RESULTS: Among the 2,393 PRAMS respondents, 217 (9.0%) self-reported a history of intimate partner violence and 228 (8.1%) of the PRAMS children experienced a maltreatment report.  Comparing respondents with an IPV history to those without, the unadjusted incidence odds ratio (IOR) of a maltreatment report was 4.70 (95%CI 3.00, 7.23).  After adjusting for income status, marital status, Alaska Native, maternal education, smoking during pregnancy, and maternal age, the adjusted IOR was 2.58 (95%CI 1.60, 4.10).

CONCLUSIONS: This study suggests an increased risk of maltreatment for children born to mothers with a history of IPV.  More sensitive familial violence screenings are needed during prenatal care through birth when physicians and other health professionals potentially have high impact contact with high risk populations.