Identifying risk factors for early childhood physical abuse

Teams from the Department of General Pediatrics and Infectious Diseases at Hôpital Necker-Enfants malades AP-HP, Université Paris Cité, Inserm and the EPI-PHARE scientific interest group, and CHU de Nantes, coordinated by midwife Flora Blangis and Professor Martin Chalumeau, have identified maternal, prenatal and postnatal factors associated with early physical child abuse.
The results of this study were the subject of a scientific publication published on May 15, 2024 in the Lancet Regional Health – Europe journal.

Child physical abuse (CPA) is defined as the intentional use of physical force against a child, including hitting, strangling or shaking. Early IPM (i.e. before the age of 1) is responsible for long-term consequences, including neurodevelopmental disorders, mental disorders and somatic diseases.

The aim of this study was to identify maternal, prenatal and postnatal factors associated with early IPM. This cohort study, based on exhaustive data from the national Mother-Child registry EPI-MERES, included all infants born in France between 2010 and 2019. Of the 6,897,384 infants included, 2,994 had an early diagnosis of MPI, at a median age of 4 months. The independent factors most strongly associated with early IPM in mothers were:

  • low financial resources;
  • less than 20 years of age;
  • alcohol use disorder;
  • an opiate use disorder;
  • be a victim of domestic violence;
  • chronic psychiatric or somatic pathology;
  • psychiatric hospitalization just before, during or after pregnancy;

and in infants :

  • extreme prematurity ;
  • a diagnosis of a severe chronic neurological pathology.

Paternal factors and the causal relationship between identified factors and IPM could not be explored due to the study design.

The maternal, prenatal and postnatal risk factors independently associated with early IPM identified for the first time at national level in France will promote a better understanding of the mechanisms of IPM and the development of effective prevention programs. This includes the creation of risk stratification tools, enabling parental guidance resources to be allocated to those parents who could benefit most.

By Flora Blangis & Martin Chalumeau


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