Parental physical disease severity and severe documented physical child abuse: a prospective cohort study

TY - JOUR

T1 - Parental physical disease severity and severe documented physical child abuse

T2 - a prospective cohort study

AU - Græsholt-Knudsen, Troels

AU - Rask, Charlotte Ulrikka

AU - Lucas, Steven

AU - Obel, Carsten

AU - Bech, Bodil Hammer

PY - 2024/1

Y1 - 2024/1

N2 - Successful prevention of physical child abuse is dependent on improvements in risk assessment. The risk of abuse is assumed to increase when family stressors overcome resources. Severe physical disease can increase stress, and parental physical disease has been studied as a risk factor for physical child abuse, but with heterogeneous definitions. This study evaluated the relation between parental physical disease severity and severe documented physical child abuse. Models were based on data on children aged 0–17 years in Denmark between 1997 and 2018, and their parents. Severe documented physical child abuse was modeled as violence against a child registered by either health authorities in treatment or mortality registries, or police authorities in cases confirmed by the courts. Parental physical disease severity was modeled as the sum of Charlson Comorbidity Index scores for the child’s parents. The causal connection was examined in two model types: a survival model comparing exposed with non-exposed children, adjusted for covariates at baseline, and a G-model, taking time-varying covariates, including income and parental psychiatric disease into account. Neither model showed an association between parental physical disease severity and severe documented physical child abuse, with RR 0.99 and 95% CI (0.93–1.05) for the survival model and RR 1.08 for the G-model (CI not calculated). Conclusion: In the model studied, parental physical disease severity was not a risk factor for severe documented physical child abuse. Individual categories of physical disease remain to be examined. Trial registration: The study was pre-registered on Open Science Framework, https://osf.io/fh2sr. (Table presented.)

AB - Successful prevention of physical child abuse is dependent on improvements in risk assessment. The risk of abuse is assumed to increase when family stressors overcome resources. Severe physical disease can increase stress, and parental physical disease has been studied as a risk factor for physical child abuse, but with heterogeneous definitions. This study evaluated the relation between parental physical disease severity and severe documented physical child abuse. Models were based on data on children aged 0–17 years in Denmark between 1997 and 2018, and their parents. Severe documented physical child abuse was modeled as violence against a child registered by either health authorities in treatment or mortality registries, or police authorities in cases confirmed by the courts. Parental physical disease severity was modeled as the sum of Charlson Comorbidity Index scores for the child’s parents. The causal connection was examined in two model types: a survival model comparing exposed with non-exposed children, adjusted for covariates at baseline, and a G-model, taking time-varying covariates, including income and parental psychiatric disease into account. Neither model showed an association between parental physical disease severity and severe documented physical child abuse, with RR 0.99 and 95% CI (0.93–1.05) for the survival model and RR 1.08 for the G-model (CI not calculated). Conclusion: In the model studied, parental physical disease severity was not a risk factor for severe documented physical child abuse. Individual categories of physical disease remain to be examined. Trial registration: The study was pre-registered on Open Science Framework, https://osf.io/fh2sr. (Table presented.)

KW - child

KW - maltreatment

KW - physical child abuse

KW - parental health

KW - risk factor

KW - causal

KW - Causal

KW - Risk factor

KW - Parental health

KW - Maltreatment

KW - Child

KW - Physical child abuse

KW - Child Abuse/diagnosis

KW - Parents/psychology

KW - Prospective Studies

KW - Humans

KW - Risk Factors

KW - Mental Disorders

UR - http://www.scopus.com/inward/record.url?scp=85174918101&partnerID=8YFLogxK

U2 - 10.1007/s00431-023-05291-8

DO - 10.1007/s00431-023-05291-8

M3 - Journal article

C2 - 37889291

SN - 0340-6199

VL - 183

SP - 357

EP - 369

JO - European Journal of Pediatrics

JF - European Journal of Pediatrics

IS - 1

ER -