Characteristics of socially high-risk pregnant women and children's outcomes.

Background: The number of reports of child abuse and neglect in Japan has increased each year. A causal relationship between socially high-risk pregnant women and child abuse is strongly suggested. This study aims to investigate the characteristics of socially high-risk pregnant women and their children's outcomes, to help prevent child abuse.

Methods: In total, 2,342 births were retrospectively analyzed from medical records. We extracted the frequency, factors, and circumstances of socially high-risk pregnant women, and the presence of social interventions for their children.

Results: There were 538 (23%) socially high-risk pregnant women out of 2,342 cases investigated. Related factors (with duplication) were: economic problems (258 cases, 48%), mental disorders (139 cases, 26%), teenage pregnancies (112 cases, 21%), multiple pregnancies (90 cases, 17%), and pregnancy conflict (73 cases, 14%). Sixty-four (12%) expectant mothers received their first health examination in late pregnancy or were not receiving pregnancy health examinations. An analysis of births showed neonatal intensive care unit hospitalization in 40% of the children born to socially high-risk pregnant women. The hospital Child Abuse Prevention Committee intervened in 71 cases, and child consultation centers intervened in 55 cases. Twenty-two children entered social care facilities and four children died of unknown causes.

Conclusions: Socially high-risk pregnant women had various social and individual problems, and received multidisciplinary interventions for child rearing support. Antenatal assessment and multidisciplinary early intervention for socially high-risk pregnant women are necessary to prevent child abuse.