Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, NC, 27599-7445, United States; Injury Prevention Research Center, University of North Carolina at Chapel Hill, 137 East Franlink St., Suite 500, Chapel Hill, NC, 27599-7505, United States. Electronic address: anna.austin@unc.edu.
We examined preconception and prenatal predictors of time to first child protective services (CPS) contact among Alaska children. Data were from the Alaska Longitudinal Child Abuse and Neglect Linkage (ALCANLink) project, a population-representative data source linking 2009-2011 Alaska Pregnancy Risk Assessment Monitoring System (PRAMS) data with administrative data sources through 2015. We examined the incidence CPS contact using the Kaplan-Meier method and predictors of CPS contact using Cox proportional hazards regression. Using data from the Alaska Permanent Fund Dividend and Child Death Review, we censored children who emigrated out-of-state or died during the study period. Significant predictors included low socioeconomic status (HR?=?2.23, 95% CI 1.68, 2.96), maternal smoking during pregnancy (HR?=?1.87, 95% CI 1.55, 2.24), unmarried maternal marital status (HR?=?1.62, 95% CI 1.31, 1.99), urban residence (HR?=?1.59, 95% CI 1.32, 1.92), lower maternal education (HR?=?1.54, 95% CI 1.24, 1.92), maternal experience of intimate partner violence in the 12 months before childbirth(HR?=?1.32, 95% CI 1.01, 1.74), Alaska Native/American Indian race (HR?=?1.40, 95% CI 1.15, 1.71), a greater number of living children (HR?=?1.20, 95% CI 1.13, 1.29), a greater number of stressful life eventsin the 12 months before childbirth (HR?=?1.16, 95% CI 1.11, 1.21), and younger maternal age at childbirth (HR?=?0.95, 95% CI 0.93, 0.97). Use of multiple linked data sources and time-to-event analysis methods adds to the growing literature regarding predictors of CPS contact. Results suggest that assessing for and addressing clinical, social, and environmental indicators during the prenatal period may aid prevention efforts in mitigating family need for involvement with CPS.