Background

The extent of intergenerational transmission of child maltreatment is unclear due to methodological limitations in previous studies. In this study, we aimed to examine factors associated with intergenerational transmission of child maltreatment and quantify its extent in a population sample over a 30-year period in South Australia.

Methods

In this retrospective cohort study, we used linked administrative data from the South Australian Birth Registry to identify dyads of mothers and their children both born in South Australia between July 1, 1986, and June 30, 2017. Three child protection system (CPS) outcomes (any CPS involvement, substantiated maltreatment, and time spent in out-of-home care) were computed from data obtained from the South Australian Department for Child Protection. Multivariable Cox regression models were used to estimate hazard ratios (HRs) for child CPS outcomes according to their mother's CPS exposure.

Findings

38 556 unique mother–child dyads were included. 458 (2·0%) of 23 437 children whose mothers had no CPS involvement in childhood had a substantiated report of maltreatment and 127 (0·5%) spent time in out-of-home care. By comparison, 970 (22·1%) of 4382 children whose mothers experienced substantiated maltreatment in childhood had substantiated maltreatment and 469 (10·7%) spent time in out-of-home care. After adjusting for potential confounders, children of mothers with any CPS involvement in childhood had an increased risk of CPS contact compared with children whose mothers had no CPS involvement; this risk was greatest for children of mothers who had both substantiated maltreatment and spent time in out-of-home care (HR 6·25 [95% CI 5·59–6·98] for any CPS involvement, 13·69 [10·08–16·92] for substantiated maltreatment, and 25·78 [18·23–36·45] for any time in out-of-home care). Risks of child CPS outcomes were substantially increased for children of mothers who had a first CPS notification under the age of 1 year or who had any CPS notification at age 13–17 years.

Interpretation

Children are at high risk of maltreatment if their mother experienced maltreatment as a child. Assisting survivors of childhood maltreatment, particularly female survivors, provides a crucial intervention opportunity to help prevent further child abuse and neglect.

Funding

Australian National Health and Medical Research Council; Channel 7 Children's Research Foundation.

中文翻译：

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1986-2017 年南澳大利亚虐待儿童的代际传播：一项回顾性队列研究

背景

由于先前研究的方法学局限性，虐待儿童的代际传播程度尚不清楚。在这项研究中，我们旨在检查与虐待儿童代际传播相关的因素，并量化其在南澳大利亚 30 年期间人口样本中的程度。

方法

在这项回顾性队列研究中，我们使用来自南澳大利亚出生登记处的关联管理数据来确定 1986 年 7 月 1 日至 2017 年 6 月 30 日期间在南澳大利亚出生的母亲及其子女的双胞胎。 三个儿童保护系统 (CPS) 结果（任何 CPS 参与、经证实的虐待和在户外护理中花费的时间）是根据从南澳大利亚儿童保护部获得的数据计算得出的。使用多变量 Cox 回归模型根据母亲的 CPS 暴露来估计儿童 CPS 结果的风险比 (HR)。

发现

包括 38556 个独特的母子二元组。在 23 437 名母亲在童年时期没有参与 CPS 的儿童中，有 458 名 (2·0%) 有被证实的虐待报告，127 名 (0·5%) 曾在户外护理中度过。相比之下，4382 名母亲在童年时期遭受过实质性虐待的儿童中，有 970 名 (22·1%) 遭受了实质性虐待，469 名 (10·7%) 花时间在户外护理。在调整了潜在的混杂因素后，与母亲没有参与 CPS 的儿童相比，在儿童时期有任何 CPS 参与的母亲的孩子接触 CPS 的风险更高；这种风险对于母亲的孩子来说是最大的，他们既受到虐待，又在户外护理中度过了时间（对于任何 CPS 参与，HR 6·25 [95% CI 5·59–6·98]，13·69 [10 ·08-16·92] 被证实的虐待，和 25·78 [18·23–36·45] 的任何时间在家外护理）。对于在 1 岁以下收到第一次 CPS 通知或在 13-17 岁收到任何 CPS 通知的母亲的孩子，儿童 CPS 结果的风险显着增加。

解释

如果他们的母亲在孩提时代遭受虐待，那么他们的孩子就很容易受到虐待。帮助童年虐待的幸存者，特别是女性幸存者，提供了一个重要的干预机会，以帮助防止进一步虐待和忽视儿童。

资金

澳大利亚国家健康与医学研究委员会；第七频道儿童研究基金会。