Risk Factors for Abuse in Children with Congenital Heart Disease Presenting at a Pediatric Tertiary Care Hospital  

作　　者：Kristi K.Westphaln Karen Kay Imagawa Lorena Espinosa Smith Julia Srivastava Nancy A.Pike 

机构地区：[1]School of Nursing,University of California,Los Angeles,California,USA [2]Department of Pediatrics,Children’s Hospital Los Angeles,Audrey Hepburn CARES Center,Los Angeles,California,USA [3]Keck School of Medicine of the University of Southern California,Los Angeles,California,USA [4]Department of Pediatrics,Critical Care Medicine,Children’s Hospital Los Angeles,Los Angeles,California,USA [5]Department of Pediatrics Heart Institute,Children’s Hospital Los Angeles,Los Angeles,California,USA

出　　处：《Congenital Heart Disease》2023年第6期657-670,共14页先天性心脏病（英文）

摘　　要：Background:Congenital heart disease(CHD)is a chronic medical condition often diagnosed at birth and requires surgical intervention,multiple hospitalizations,and lifelong care.This can put significant stress on the family,leading to altered maternal mental health,bonding and attachment issues,and the potential for child abuse.The purpose of this study is to explore the characteristics of a sample of young children with CHD who experienced hospitalization with concurrent concern for child abuse in a free-standing pediatric tertiary care hos-pital.Methods:Electronic medical records were reviewed for children aged 0–5 years old who were hospitalized with concern for child abuse between 2016 and 2020.Variables were extracted related to the history of presenta-tion,and sociodemographics including SDOH,admission,and discharge condition/follow-up.Descriptive statis-tics were used to characterize the sample and correlations to identify an association with abuse type.Results:Out of 251 hospitalizations involving concern for child abuse,49(19.5%)had a diagnosis of CHD.The majority of cases were neglect(51%),<1 year of age(80%),male(57%),Hispanic ethnicity(45%),and publicly insured(90%).CHD severity was moderate to severe(71%)with multiple co-occurring medical conditions(genetic syn-drome,failure to thrive(FTT),prematurity,history of a feeding tube,developmental delay,and intrauterine drug exposure).Correlations associated with physical abuse were age,maternal mental health,head injury,and history of Child Protective Services(CPS)involvement.Neglect correlated with age,FTT,head injury,history of a feeding tube,previous CPS involvement,and substance use.Correlates specifically related to prenatal substance use included age,maternal mental health status,history of domestic violence,CPS involvement,feeding tube,FTT,lack of housing,employment status,and public insurance.Conclusions:Our study highlights the risk for abuse in children with CHD,regardless of defect severity.The most common abuse type was neglect(mostly prenatal

关 键 词：Child maltreatment intrauterine substance exposure failure to thrive 

分 类 号：R725.4[医药卫生—儿科]