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Higher Risk of Poor Child Outcomes: The Louisiana Risk Assessment, Infant version

Higher Risk of Poor Child Outcomes: The Louisiana Risk Assessment, Infant version. Candice Wilson BS , Jean Valliere, LCSW, Lyn Kieltyka PhD, MPH Louisiana State University School of Public Health, Louisiana Office of Public Health, Maternal and Child Health Program.

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Higher Risk of Poor Child Outcomes: The Louisiana Risk Assessment, Infant version

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  1. Higher Risk of Poor Child Outcomes:The Louisiana Risk Assessment, Infant version

  2. Candice Wilson BS, Jean Valliere, LCSW, Lyn Kieltyka PhD, MPH Louisiana State University School of Public Health, Louisiana Office of Public Health, Maternal and Child Health Program

  3. The Louisiana Risk Assessment (LRA), Infant Version • One page screen by nurse in WIC clinics • Includes 24 items • Basic demographics • Obstetrical history • Infant behavior • Maternal perception of infant

  4. LRA (cont’d) • Open ended questions coded and scored by clinical infant mental health specialist • “Tell us about the baby’s behavior.” • Positive • Negative • Neutral

  5. Objectives of LRA • Identify risk factors for poor child outcomes • Realize public health effects • Make referrals to appropriate social service agency

  6. Study Sample • 912 Louisiana mothers of newborns receiving WIC benefits

  7. Basic Demographics • Maternal Age • 17.3% <20 yrs. • 82.7% 20+ yrs. • Education • 26.8% less than high school • 43.9% high school diploma, GED • 29.3% college or more

  8. Basic Demographics (cont’d) • Marital status • 39.6% unmarried • 47.5% married or unmarried & living together • 12.9% separated, divorced, or widowed • # of times family has moved in past year • 60.3% no moves • 32.6% moved once • 7.1% moved more than once

  9. Other Demographics • 26.2% had problems during pregnancy • 19.3% had infants that had been sick or hospitalized • 22.7% had problems with infant’s sleeping, eating, or colic (IPSEC) • 34.4% unsatisfied with timing of pregnancy

  10. Other Demographics (cont’d) • 4.3% reported having behavior or emotional problems • 6.0% reported being currently depressed • 12.8% reported being depressed during or after pregnancy

  11. Other Demographics (cont’d) • Maternal perception of infant behavior • 6.2% negative • 66.0% positive • 27.8% neutral

  12. Methods • Descriptive frequencies w/ Χ2 tests • Multivariable logistic regression

  13. Results-Bivariate Analysis • Associations with perinatal depression and negative maternal perception • Pregnancy intention (p<0.05) • Moving (p<0.05) • IPSEC (p<0.0001) • Association with negative maternal perception • Maternal education (p<0.05)

  14. Results-Logistic Regression • Associations with perinatal depression • Moving more than once (OR=4.4,95%CI=2.3,8.2) • IPSEC (OR=2.0,95%CI=1.3,3.1) • Uninteded pregnancy (OR=1.8,95%CI=1.2,2.7) • Associations with negative maternal perception • Moving more than once (OR=2.7,95%CI=1.1,6.7) • IPSEC (OR=5.2, 95%CI 2.8,9.6)

  15. Conclusion • Risk factors for both perinatal depression and negative maternal perception • Moving more than once in one year • IPSEC • Risk factors for perinatal depression only • Unintended pregnancy

  16. Public Health Implications • Risks to healthy maternal behavior and healthy attachment relationship to child • Higher risk of poor child behavior • Role of healthcare professionals • Screen mothers for risk factors • Refer at risk mothers to appropriate social services

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