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2025 ; 25
(1
): 1101
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
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English Wikipedia
Contact with child protection services during pregnancy: a cross-sectional study
using the eLIXIR Born in South London, UK maternity-child data linkage
#MMPMID41102650
De Backer K
; Seed P
; Burton S
; Montgomery E
; Sandall J
; Easter A
BMC Pregnancy Childbirth
2025[Oct]; 25
(1
): 1101
PMID41102650
show ga
BACKGROUND: In the last decade, rates of children with child protection agency
involvement have increased in many high-income countries, including the UK.
Disparities in both maternal and child health outcomes as well as child welfare
referrals have been widely evidenced, yet no previous research has investigated
contact with child protection agencies in the UK (Children?s Social Care, CSC)
during pregnancy using linked maternity and mental health records. The aim of
this study was to investigate characteristics of pregnant women when child
protection agencies are involved and investigate what risk factors are associated
with child protection agency contact during pregnancy. METHODS: We conducted a
retrospective cross-sectional study using linked electronic health records from
maternity, neonatal, and mental health services in South London (eLIXIR-BiSL
cohort). A cohort of singleton pregnancy records was created (October 2018 ?
April 2023). We used descriptive statistics to investigate sociodemographic and
clinical characteristics, and binomial regression to explore risk factors and
characteristics associated with CSC contact during pregnancy. RESULTS: A cohort
of 36,322 singleton pregnancy records was studied, with CSC contact identified in
2,206 records (6%). CSC contact was most frequently observed among Black and
multiparous women, and those living in poorer socio-economic circumstances. Those
with CSC contact more often had recorded medical, obstetric and psychiatric
comorbidities compared to those without CSC contact. When investigating referral
indications associated with CSC contact, we found 1,733 pregnancy records with
risk factors indicating referral concordant with local guidance yet without any
CSC contact. In contrast, in 913 pregnancies CSC contact occurred without any
prescribed referral indication being identified. In this group, CSC contact was
more frequently associated with Black or mixed ethnicity, social deprivation,
maternal unemployment, single motherhood, maternal age under 25 years, previous
domestic abuse disclosures, and previous mental health or CSC contact.
CONCLUSIONS: In this UK population cohort, socio-economic and ethnic disparities
were observed between those in contact with child protection agencies during
pregnancy and those without. This continued to be observed when excluding those
with referral indications associated with CSC involvement. Consistent guidance
and a strengths-based family approach is needed to address referral disparities
for this group of women and birthing people. SUPPLEMENTARY INFORMATION: The
online version contains supplementary material available at
10.1186/s12884-025-08197-5.