Breaking News
March 24, 2019 - Practices for Reducing COPD Hospital Readmissions Explored
March 24, 2019 - Could an eye doctor diagnose Alzheimer’s before you have symptoms?
March 24, 2019 - Enzyme inhibitor stops inflammation and neurodevelopmental disorders in mouse models
March 24, 2019 - Walk, Dance, Clean: Even a Little Activity Helps You Live Longer
March 24, 2019 - Americans used less eye care in 2014 versus 2008
March 24, 2019 - Study finds link between depression in 20s linked to memory loss in 50s
March 24, 2019 - New tool helps physiotherapy students to master complex fine motor skills
March 24, 2019 - The AMR Centre secures £2.3m funding boost
March 24, 2019 - Study examines effects of taking ondansetron during first trimester of pregnancy
March 24, 2019 - Researchers identify a more effective treatment for cancer
March 24, 2019 - Open-source solution for multiparametric optical mapping of the heart’s electrical activity
March 24, 2019 - New nanotechnology approach shows promise in treating triple negative breast cancer
March 24, 2019 - Trevena Announces Publication of APOLLO-1 Results in The Journal of Pain Research Highlighting Oliceridine’s Potential for Management of Moderate-to-Severe Acute Pain
March 24, 2019 - Maternal deaths following C-section 50 times higher in Africa compared to high-income countries
March 24, 2019 - Apple watch could detect irregular heart beat says study
March 24, 2019 - Queen Mary University of London’s BCI boosts radionuclide imaging capabilities with MILabs VECTor technology
March 24, 2019 - Girls should be encouraged to gain more ball skills, shows study
March 24, 2019 - Acute doses of synthetic cannabinoid can impair critical thinking and memory
March 24, 2019 - Presence of bacteria in urine does not always point to infection, shows study
March 24, 2019 - Scientists identify a new role for nerve-supporting cells
March 24, 2019 - Hidden differences between pathology of CTE and Alzheimer’s disease discovered
March 24, 2019 - Knowing causative genes of osteoporosis may open door to more effective treatments
March 24, 2019 - Toilet-seat based cardiovascular monitoring system getting ready to begin commercialization
March 24, 2019 - New model for intensive care identifies factors that send ill patients to ICU
March 24, 2019 - Recommendations Issued for HSCT in Multiple Myeloma
March 24, 2019 - Deep brain stimulation provides sustained relief for severe depression
March 24, 2019 - “Statistical significance” may soon be a thing of past?
March 24, 2019 - Researchers track effects of epigenetic marks carried by sperm chromosomes
March 24, 2019 - AHA News: Family Adopts Three Children With Three Different Heart Conditions
March 24, 2019 - Research into opioid painkillers could provide clues for safer drug development
March 23, 2019 - Lung cancer survivor recounts her lifetime struggles
March 23, 2019 - Radial and femoral approach for PCI achieve similar results in terms of survival
March 23, 2019 - Study sheds light on the optimal timing of coronary angiography in NSTEMI patients
March 23, 2019 - Excess hormones could cause a condition that can lead to blindness in women, study finds
March 23, 2019 - Dramatic shifts in first-time opioid prescriptions bring hope, concern
March 23, 2019 - Antidepressant drugs may not work when neurons are out of shape
March 23, 2019 - TTUHSC El Paso to establish endowed chair in neurology through a major grant
March 23, 2019 - New device approved by FDA for treating patients with moderate-to-severe heart failure
March 23, 2019 - People with peripheral artery disease have lower Omega-3 Index, shows research
March 23, 2019 - Trigger warnings have minimal impact on how people respond to content, shows research
March 23, 2019 - Gilead Announces Data From Two Studies Supporting Further Development of GS-6207, a Novel, Investigational HIV-1 Capsid Inhibitor as a Component of Future Long-Acting HIV Therapies
March 23, 2019 - Selfish genetic elements amplify inflammation and age-related diseases
March 23, 2019 - Study provides new understanding of how the brain recovers from damage caused by stroke
March 23, 2019 - CRISPR/Cas libraries could revolutionize drug discovery
March 23, 2019 - Allergic reaction during pregnancy may alter sexual-development in offspring’s brain
March 23, 2019 - Seeing through a robot’s eyes helps those with profound motor impairments
March 23, 2019 - Recent research shows that ease of breastfeeding after C-section differs culturally
March 23, 2019 - Newly discovered parameters offer more control over efficient release of drugs
March 23, 2019 - ‘De-tabooing’ of abortion- Women would like more support from health care community
March 23, 2019 - Anti-TB drugs can increase susceptibility to Mtb reinfection
March 23, 2019 - New survey indicates need of attention to neglected tropical diseases
March 23, 2019 - Innovative in vitro method to develop easy-to-swallow medicine for children and older people
March 23, 2019 - Sugary drinks could raise risk of early deaths finds study
March 23, 2019 - Lian wins ENGINE grant for stem-cell-based therapy to treat Type 1 diabetes
March 23, 2019 - Overall, Physicians Are Happy and Enjoy Their Lives
March 23, 2019 - Researchers discover how blood vessels protect the brain during inflammation
March 23, 2019 - CDC study shows modest improvement in optimal hospital breastfeeding policy
March 23, 2019 - Family-based prevention program to reduce alcohol use among older teens
March 23, 2019 - Remote monitoring of implanted defibrillators in heart failure patients prevents hospitalizations
March 23, 2019 - Appropriate doffing of personal protective equipment may reduce healthcare worker contamination
March 23, 2019 - Window screens can suppress mosquito populations, reduce malaria in Tanzania
March 23, 2019 - Researchers discover new biomarker for postoperative liver dysfunction
March 23, 2019 - Pregnancy history may be linked to cognitive function in older women, finds study
March 23, 2019 - Study shows ticagrelor is equally safe and effective as clopidogrel after heart attack
March 23, 2019 - FDA Approves First Drug for Postpartum Depression, Zulresso (brexanolone)
March 23, 2019 - New guidelines outline new treatment management for psoriasis
March 23, 2019 - Thermally abused cooking oil may promote progression of breast cancer
March 23, 2019 - High-fructose corn syrup fuels growth of colon tumors in mice
March 23, 2019 - Partnership aims at establishing best practices to promote diversity in clinical trials
March 23, 2019 - New study examines presence of microbes in tap water from residences, office buildings
March 23, 2019 - Early life trauma may affect brain structure, contribute to major depressive disorder
March 23, 2019 - NIH starts clinical trial of drug to treat cravings associated with opioid use disorder
March 23, 2019 - Cervix bacteria, immune factors could be a warning signal of premature birth, reports new research
March 23, 2019 - Worst-ever emergency care performance figures underscore the need to focus on staffing
March 23, 2019 - The Current issue of “The view from here” is concerned with Cancer
March 23, 2019 - Mouse model validates how ‘good’ and ‘bad’ bacteria affect acne
March 23, 2019 - Individual amygdala neurons respond to touch, imagery and sounds
March 23, 2019 - Combination of two topical creams can prevent cancer
March 23, 2019 - Study suggests depression screening when assessing African-Americans for schizophrenia
March 23, 2019 - New electronic support system for choosing drug treatment based on patient’s genotype
Risk Score May Reveal if Kids are Victims of Ill-Treatment

Risk Score May Reveal if Kids are Victims of Ill-Treatment

image_pdfDownload PDFimage_print

Action Points

  • A maltreatment risk score was able to identify which children were more likely to be in danger of post-neonatal death and hospitalization.
  • The “very high risk” group of children were more likely to have a single mother, a mother age <20, and to live in a family with high parenting demand.

A maltreatment risk score was able to identify which children were more likely to be in danger of post-neonatal death and hospitalization, researchers found.

Children who were flagged at the 10% and 20% risk thresholds had more than four times higher risk of post-neonatal mortality and and a higher risk of hospitalization, reported Rhema Vaithianathan, PhD, of Auckland University of Technology in New Zealand, and colleagues.

Prior research found “linked administrative data and predictive risk models” can be used to identify which children have a greater risk of abuse and neglect, they wrote in writing in Pediatrics.

“If children identified by a [predictive risk model] for maltreatment are at risk for negative health outcomes beyond simply child protection involvement, these families should be prioritized for a broader swath of higher intensity preventive services,” the authors wrote.

Researchers used the Integrated Child Dataset, a census for all live births in New Zealand from 2004 to 2011, which is also linked to health, welfare benefits, child protective services and criminal justice registers to determine a risk score for children born in 2011.

They estimated a child’s probability of being “a victim of maltreatment” by the age of 2 years, using the “predictors” of child characteristics and family background. Certain factors shown to be predictive of maltreatment risk included:

  • Preterm birth (prior to 37 weeks gestation)
  • Infant’s sex (girl)
  • High parenting demand (more than three children in the family, multiple birth children or multiple children ages <2 years)
  • Maternal characteristics, such as age <25 or age >35
  • Marital status (single)
  • Receipt of public income support
  • History of mental health or substance abuse
  • Criminal records in last 5 years

After ranking children according to their probability of maltreatment, they estimated mortality and injury rates by age 3 for the children with the highest probability of maltreatment. Researchers then examined the top 10% of the risk score distribution as “very high risk” and the top 20% as “high risk.”

The “very high risk” group of children were more likely to have a single mother, a mother age <20, and to live in a family with high parenting demand. Not surprisingly, past or current child protective services involvement was "more prevalent" among "very high risk" children. Similar patterns were seen among the top 20%, or the "high risk" group of children.

Overall, children in the “very high risk” group were 4.8 times more likely to die in infancy (95% CI 3.2-7.2) versus other children. Their relative risk ratio was 9.0 for injury deaths overall (95% CI 3.9-20.7), the authors said, albeit with an extremely wide confidence interval.

The “very high risk” group was also two times as likely (95% CI 1.8-2.2) to be hospitalized versus other children, and hospitalizations for long bone fractures by age 2 was 2.6 times more likely to occur among this group (95% CI 1.7-4.0).

In an accompanying editorial, Brett Drake, PhD, and Melissa Jonson-Reid, PhD, both of Washington University in St. Louis, characterized this as a “breakthrough” in using predictive risk modeling to predict negative child outcomes.

“Until now, preventive services have been parent-initiated or from a hotline referral. This system breaks down relative to child fatalities because most fatalities happen early,” the editorialists wrote. “Creating such a program in the United States … would represent a paradigmatic change in how we see the role of the state in protecting children and supporting families, supplementing the current hotline-gated system with an empirically sound and timely, preventive system.”

Study limitations included some potential problems with data linkage and that the analysis was limited only to children in New Zealand, and not the immigrant children born into the country. Also, the researchers only looked at outcomes into early childhood, so the results would not be generalizable to outcomes at older ages.

Vaithianathan and co-authors, as well as Drake and Jonson-Reid, disclosed no relevant relationships with industry.

  • Reviewed by
    Robert Jasmer, MD Associate Clinical Professor of Medicine, University of California, San Francisco and Dorothy Caputo, MA, BSN, RN, Nurse Planner

1969-12-31T19:00:00-0500

last updated

Tagged with:

About author

Related Articles