Predicting Physical Abuse Based on Risk Factors Identified in the Newborn
LewisFirst, MD, MS, Editor in Chief, Pediatrics
If we could identify who is at risk for child abuse before it occurs, we might be
able to prevent physical abuse from occurring. Puls et al. (10.1542/peds.2018-2108) set out to describe the prevalence of risk factors for physical abuse in early infancy.
They studied a national birth cohort of over 3.7 million newborns and a database
that focused on readmission of that cohort. A variety of demographic and psychosocial
data were tracked, and then subsequent hospitalizations linked via their database.
Only 1247 infants were rehospitalized for abuse 6 months after birth, of which 20%
were preterm or low birthweight and 4.1% drug exposed. The findings show that these
two factors were associated with increased readmissions for abuse, whereas having
medical complexity or a non-cardiac birth defect was not associated with subsequent
abuse. The authors identify a host of factors that indicate those infants at greatest
risk for abuse, but I’ll only provide a small dose of data from this study so that
you will read the study for yourself. This study raises the question about if you
find yourself with a newborn who classifies at high risk for subsequent abuse based
on the findings in this study, could early intervention to prevent abuse from occurring?