Risk for death increased for infants after maltreatment report

(HealthDay)—Infants reported for alleged maltreatment have an increased risk for death attributable to medical causes, according to a study published online Aug. 23 in Pediatrics.

Janet U. Schneiderman, Ph.D., R.N., from the University of Southern California in Los Angeles, and colleagues linked birth and death records for all 3,455,985 children born in California between 2010 and 2016 to administrative child protection system records. Infants were followed prospectively from birth through death or age 1 year. The adjusted relative hazard of postneonatal infant death attributed to a medical cause was estimated in stratified, multivariable competing risk models.

The researchers found that the medical-related mortality risk was significantly higher for infants reported once for maltreatment compared with infants never reported for maltreatment after adjustment for baseline risk factors (hazard ratio, 1.77), and it was even higher if there was more than one maltreatment report (hazard ratio, 3.27). Periods of foster care placement reduced the risk for death by about half among infants reported for maltreatment.

"The increased risk of infant death from a medical cause associated with a previous report of abuse or neglect underscores the importance of ongoing care coordination between child protection system and pediatric providers," the authors write. "Our findings also suggest that during periods of foster care placement, infants may receive a level of case management and care coordination that protects against death and other health and developmental adversities."

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