Prenatal screening of pregnant mothers for parenting difficulties: final results from the Queen Mary Child Care Unit.

This paper reports the results of 10 years of research into the prenatal identification of mothers likely to have major parenting problems. Previous published research reported the development of a set of criteria for determining risk status. These criteria were used to classify into four levels of risk a sample of mothers who were consecutive enrollments for prenatal care. The sample was monitored through various social agencies for 2 years. Results of this monitoring indicate the predictive validity of the risk code in an unselected sample. The value of prenatal identification of the 'at risk' is discussed together with the procedures adopted for implementing routine screening in the maternity hospital. The issue of causation, as distinct from prediction, is addressed.

Prenatal screening for risk of major parenting problems: further results from the Queen Mary Maternity Hospital Child Care Unit.

This research revealed in Stage I the ability to identify during the prenatal period women at risk for possible child abuse and in Stage II an intervention program which when introduced resulted in fewer high-risk mothers relinquishing the care of their infants. The research had two main aims: to use the data from Stages I and II to reassess the criteria for identifying "at risk" mothers, and to develop a brief, easily administered screening questionnaire which could be standardized for widespread prenatal use; and to collect data on a random sample of prenatal patients, to use these data for confirming the validity and stability of the screening procedures, and to estimate the incidence of potentially high-risk mothers in an urban population.

Predicting and preventing parenting problems.

Over a ten year period a psychosocial risk scoring system for antenatal and perinatal use has been developed. A nine item questionnaire which can be administered by a range of health care personnel has been shown to predict future parenting problems. It has also been shown that the provision of special social interventions has been associated with a reduced likelihood of serious parenting failure, and that mothers who have been identified as being in a high risk group are likely to use such services when they are offered. We believe that by screening the whole obstetric population into no risk (78%) and some risk (22%) groups, limited social work services can be focused on areas of need.

Predicting child abuse and neglect in New Zealand.

We describe the three stages of our attempt to predict parenting problems and child abuse antenatally. In the first stage, we made an intuitive check list of ten items from 173 risk factors drawn from the literature. The check list was useful in predicting who would relinquish care or have major parenting difficulty in two different samples drawn four years apart and before and after some major sociocultural changes in New Zealand. In the second stage we used statistical techniques rather than intuition to maximise the predictive ability of the checklist and produced a new one of 9 items. In the third stage we validated the new list in a random sample of pregnant mothers. It was effective in predicting parenting difficulty in the 2 years after childbirth. We recommend it for routine use in a New Zealand setting. We do not know how useful the checklist will be in other cultural settings.