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. 2016;26(1):4-13.
doi: 10.2188/jea.JE20140216. Epub 2015 Dec 5.

Self-Reported Prevalence and Risk Factors for Shaking and Smothering Among Mothers of 4-Month-Old Infants in Japan

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Self-Reported Prevalence and Risk Factors for Shaking and Smothering Among Mothers of 4-Month-Old Infants in Japan

Takeo Fujiwara et al. J Epidemiol. 2016.

Abstract

Background: To estimate the prevalence of shaking and smothering and to determine risk factors in a population-based sample of mothers with 4-month-old infants in Japan.

Methods: We administered a questionnaire to women who participated in a 4-month health checkup program in Aichi Prefecture, Japan (n = 6487; valid response rate, 66.8%), and assessed frequency of shaking and smothering during the past 1 month, as well as maternal, infant, and familial characteristics. Associations of shaking, smothering, and either shaking or smothering with possible risk factors were analyzed using multiple logistic regression.

Results: Self-reported prevalence of shaking, smothering, and either shaking or smothering at least once during the past month was 3.9% (95% confidence interval [CI], 3.5%-4.4%), 2.7% (95% CI, 2.3%-3.1%), and 5.4% (95% CI, 4.9%-6.0%) respectively. Several different risk factors were found for shaking and smothering. Risk factors for either shaking or smothering were age 34 years or younger (especially 24 years or younger), age 40 years or older, full-time working, later attendance at 4-months health checkup, primiparity, living in a detached house, living on the 2nd floor or higher (especially on the 10th floor or higher), economic adversity, perceived excessive crying, and postpartum depression. Protective factors against infant abuse were living in a four-room house and having a larger number of people to consult with.

Conclusions: Self-reported prevalences of shaking and smothering among mothers in Japan were similar to prevalences reported in western countries. These finding may be useful for identifying mothers at increased risk of shaking and smothering their infants.

背景:: 日本の人口ベースのサンプルを用いて、4か月の乳児をもつ母親の揺さぶりと口塞ぎの存在割合を推定し、リスク因子を明らかにすること。

方法:: 愛知県45市の4か月健診を受診した母親に質問紙調査を実施した(N=6,487, 有効回答率: 66.8%)。その質問紙で、過去1か月間の揺さぶりおよび口塞ぎの頻度、母親・子の特性、世帯の状況について調査した。そして、これらリスク因子と揺さぶり、口塞ぎ、揺さぶりまたは口塞ぎとの関連をロジスティック回帰分析によって検討した。

結果:: 自己申告による過去1か月の1回以上の揺さぶり、口塞ぎ、そのどちらかの存在割合は、それぞれ3.9%(95%信頼区間:3.5%-4.4%)、2.7%(95%信頼区間:2.3%-3.1%), 5.4% (95% 信頼区間:, 4.9%-6.0%)であった。揺さぶりまたは口塞ぎのリスク因子は、母親の年齢が34歳以下(特に24歳以下)または40歳以上、母親が常勤で勤務していること、4か月健診の受診月齢が遅いこと、初産、一戸建て居住、2階以上の集合住宅(特に10階以上の集合住宅)の居住、主観的経済状況の悪さ、泣きの量を多いと感じること、産後うつ、であった。保護因子としては部屋の数が4つあること、そして相談できる人の数が多いこと、であった。

結論:: 日本における自己申告の揺さぶりおよび口塞ぎの存在割合は欧米諸国と同等であった。この研究結果が、揺さぶりや口塞ぎといった乳児虐待のリスクを持つ母親を特定することに役立つかもしれない。

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