title: Special care needs and risk for child maltreatment reports among babies that graduated from the Neonatal Intensive Care.
abstract: Newborns discharged from intensive care are at elevated risk for child welfare reports, especially for child neglect. This study investigates the role of caregiving burden as a risk predictor among the NICU graduate population. Discharge data were captured for 2,463 infants graduating from a Neonatal Intensive Care Unit (NICU) during 2005-2008, then linked to child welfare reports at a median 3.2 year follow-up. Survival analyses were used to examine child welfare report outcomes conditional on caregiving burden and its moderating relationships with other family risk factors. Caregiving burden was associated primarily with an increased risk of child welfare reporting during the first few months to first year of life, after which risk was similar to NICU graduates without caregiving burden. Caregiving burden effects were potentiated by having three or more siblings in the family. A history of prior child welfare reports predicted very high risk, regardless of caregiving burden. Young maternal age increased risk. The findings suggest that the immediate months after NICU discharge may be an important window of child neglect prevention opportunity among newborns with special caregiving needs. This may be a key time to provide caregiver support and monitoring, particularly when caregivers have multiple children.
authors.affiliation: Department of Pediatrics, University of Oklahoma Health Sciences Center, USA.
authors.forename: Raja
authors.initials: R
authors.lastname: Nandyal
authors.affiliation: Department of Pediatrics, University of Oklahoma Health Sciences Center, USA.
authors.forename: Arthur
authors.initials: A
authors.lastname: Owora
authors.affiliation: Department of Pediatrics, University of Oklahoma Health Sciences Center, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Risch
authors.affiliation: Department of Pediatrics, University of Oklahoma Health Sciences Center, USA.
authors.forename: David
authors.initials: D
authors.lastname: Bard
authors.affiliation: Department of Pediatrics, University of Oklahoma Health Sciences Center, USA.
authors.forename: Barbara
authors.initials: B
authors.lastname: Bonner
authors.affiliation: Department of Pediatrics, University of Oklahoma Health Sciences Center, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Chaffin
mesh_terms: D000367:Age Factors; D017028:Caregivers / Q000523:psychology*; D002649:Child Abuse / Q000517:prevention & control / Q000706:statistics & numerical data*; D002669:Child Welfare / Q000706:statistics & numerical data*; D002675:Child, Preschool; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal; D008297:Male; D008423:Maternal Age; D010287:Parent-Child Relations; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D035781:Siblings; D013315:Stress, Psychological
keywords: Caregiving burden; Child maltreatment; NICU; Risk assessment