In connection to yesterday’s blog for increased visibility of child abuse in the U.S., newly published research in the Maternal and Child Health Journal assessing the relationship between birth spacing and child maltreatment may broaden our understanding of how to combat the problem.

Rationale: An objective of Health People 2020 states that births should be spaced greater than 18 months (Objective FP-5), based on evidence of improved maternal social and infant health outcomes in increased lengths between births.

Methodology: Using a home visiting Healthy Start program, eligible participants were recruited via a family stress checklist to see if they were at-risk for child maltreatment. Researchers focused on the index child of a rapid repeat birth (RRB)—“the child born immediately prior to a subsequent child in a birth interval.” A baseline interview was conducted within a month of delivery and follow-up collected at age 2 and 7.  RRB was defined as a child born within 24 months of an index child for mothers age 20 and older, and as subsequent birth before age 20 for females age 19 and under.

Variables:

• Parental stress tactics—adjustment problems, child abuse (physical), neglect
• Child Protective Service (CPS) reports
• Child behavior—adaptive behavior and social skills
• Child development—memory, verbal, abstract and quantitative reasoning

Results: RRB did not influence parenting behaviors, including stress and child physical abuse. However, there was an association between RRB and parental neglect. In addition, women with a RRB were more likely to have a substantiated CPS report in their name (after controlling, there was a relative risk of 1.8 compared to women without a RRB).

In addition, index children who had mothers with a RRB had poorer behavioral outcomes and poorer developmental outcomes compared to families without a RRB.

Implications for MCH professionals: These associations can be used to help educate health departments for interventions on increasing birth spacing. Findings are consistent with other research that has reported birth spacing associated with neglectful rather than abusive parenting. Targeting subgroups of children, including index or subsequent children, and mothers who are at risk or show neglectful behavior, may be necessary.

Shea Crowne, S., Gonsalves, K., Burrell, L., McFarlane, E., & Duggan, A. (2011). Relationship Between Birth Spacing, Child Maltreatment,and Child Behavior and Development Outcomes Among At-Risk Families. Maternal and Child Health Journal.