Introduction
Preventing child maltreatment and reducing adverse childhood experiences is critical
for improving adult health. To inform prevention efforts, it is necessary to move
beyond static risk models and instead model the dynamic changes in household challenges
during the prebirth and early childhood periods. This study examined the effect of
changes in the number of household challenges from prebirth (12 months before birth
of a child) to early childhood (3 years after birth) period on the risk of a child
maltreatment report by age 3 years.
Methods
This retrospective cohort study linked data from the Alaska 2009–2011 Pregnancy Risk
Assessment Monitoring System, its 3-year follow-up survey, and administrative records
through 2019. Participants were 1,699 birthing parents. Latent class analyses identified
prebirth and early childhood low- and high-challenge respondent groups on the basis
of the level of reported household challenges. The authors then modeled the relationships
between group transition membership and the risk of maltreatment using latent transition
analysis. Analyses were conducted in 2021.
Results
Households transitioning from a high-challenge-prebirth status to a low-challenge-early-childhood
status had a lower predicted risk for child services report than households remaining
in the high-challenges group. Transitioning from low- to high-challenges status predicted
the highest risk for child services report than that of all other groups.
Conclusions
To reduce the risk of child maltreatment and subsequent adverse childhood experiences,
healthcare providers should screen parents for the presence of household challenges
during both pregnancy and early childhood and connect patients to resources targeted
at reducing those challenges and providing continuous familial support.
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Article info
Publication history
Published online: January 21, 2023
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© 2022 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
