Identification of risk-and preventive factors predicting child maltreatment in pregnant women with psychosocial problems

Michi Ogawa¹Tasuku Hashimoto^1,2,3*Mami Tanaka⁴Hiroki Ishii^1,2,3Ryota Seki¹Aiko Sato^1,2Atsushi Kimura¹Jun Okayama⁵Mamiko Endo⁶Naoki Saito⁷Masaomi Iyo^1,2

• ¹Department of Psychiatry, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan
• ²Department of Psychiatry, Narita Hospital, International University of Health and Welfare (IUHW), Narita, Chiba, Japan
• ³Department of Psychiatry, Sodegaura Satsukidai Hospital, Sodegaura, Japan
• ⁴Department of Psychology, Faculty of Liberal Arts, Teikyo University, Hachiogi, Japan
• ⁵Department of Obstetrics and Gynecology, Chiba University Hospital, Chiba, Japan
• ⁶Department of Pediatrics, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan
• ⁷Department of Legal Medicine, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan

Introduction: Pregnant women with psychosocial problems experience various parenting struggles, which, in the absence of adequate social support, can lead to child maltreatment. This study aimed to identify risk- and preventive factors for child maltreatment among pregnant women with psychosocial problems to facilitate the appropriate allocation of social support.Methods: This retrospective cohort study analyzed electronic medical records of all consecutive pregnant women with psychosocial difficulties who visited and delivered at Chiba University Hospital, and were registered with the hospital’s child protection team between April 2016 and March 2019. The primary objective was to identify risk- and preventive factors associated with child maltreatment, defined as cases requiring intervention by a child guidance center. Multiple logistic regression analysis was performed to identify the risk factors and preventive factors influencing child maltreatment within the first month postpartum.Results: A total of 253 pregnant women were included in the analysis, of whom 54 were reported for child maltreatment. Maternal grandmother’s support (OR: 7.85, 95%CI [3.47–17.77]) and other family members’ support (OR: 3.57, 95%CI [1.51–8.41]) were identified as preventive factors. Maternal mental illness (OR: 0.40, 95%CI [0.18–0.89]) was identified as a risk factor. Additionally, the higher the mother’s age (OR: 1.08, 95%CI [1.02–1.14]), the lower the incidence of child maltreatment, indicating that adolescent pregnancy is also a risk factor.Conclusions: Family support, particularly from the maternal grandmother, plays a crucial role in enhancing parenting skills of women with psychosocial difficulties. Assessing these factors and integrating them into public support initiatives could contribute to the prevention of child maltreatment.