Stressed parents with infants: Reassessing physical abuse risk factors

Objective: This study aimed to examine the relationship between a range of potentially adverse psychosocial and demographic characteristics identified in the immediate postpartum period and child physical abuse potential at 7 months. Method: Data collected as part of a randomized controlled trial of a nurse home visiting programme for vulnerable families with newborn, was used. Wom en (181) were recruited in the immediate postpartum period. At 7 months, 15 1 participants were available for evaluation. Potential for child physical abuse was assessed using thr Child Abuse Potential (CAP) Inventory. Results: Significant risk indicators identified by univariate analysis were financial stress, elevated Edinburgh Postnatal Depression Scale (EPDS) sco res, education level less than 10 years, concern regarding the provision of housing, and domestic violence characterized by verbal and social abuse. T here was no association between child abuse potential and sole parenthood, poverty, young maternal age, history of childhood abuse, of psychiatric his tory. Two variables were found to be of independent significance using a lo gistic regression model. elevated EPDS and perceived difficulty "making end s meet." Conclusions: The findings indicate that perceived stress relating to financ es, accommodation and relationships in the immediate postpartum period are associated with heightened child physical abuse potential at 7 months. Elev ated EPDS in the early postpartum period is also a risk indicator. The outc ome of this study suggests that perinatal assessment of child abuse risk is possible and simple and is related to perceived stressors at the time surr ounding delivery. This is independent of a range of demographic variables t raditionally thought to predict high risk. (C) 1999 Elsevier Science Ltd.