Associations between maternal child maltreatment predict their child's health service use? Results from the I-CALM study.

BACKGROUND

Child maltreatment (CM) is associated with lifelong adverse outcomes but less is known about its intergenerational consequences. As these consequences often manifest as poor health, examining health service use provides an objective measure of clinically significant morbidity and healthcare burden in children.

OBJECTIVES

We investigated whether maternal CM history predicted offspring health service utilisation using an intergenerational dataset.

PARTICIPANTS AND

SETTING

Multigenerational retrospective cohort study.

METHODS

We analysed data from the Intergenerational Childhood Adversity and Lifetime Morbidity (I-CALM) study, comprising 1696 women who gave birth to 3296 children in Queensland, Australia, between 2008 and 2024. Maternal CM was defined using government records as notified or substantiated. Linked statewide records provided offspring health outcomes, including hospital admissions or emergency department (ED) presentations. Logistic and negative binomial regressions assessed dichotomous and count outcomes, adjusting for child age, gender, and significant maternal covariates.

RESULTS

Maternal notified and substantiated CM were significantly associated with higher risks of offspring ED presentations for deliberate self-harm (OR = 2.69, 95% CI 1.39-5.20; OR = 2.57, 95% CI 1.15-5.75, respectively). Maternal CM was also linked to greater odds of offspring hospital admissions for external injury (OR = 1.45-1.64). Associations between maternal CM and increased number of total ED presentations were also found.

CONCLUSION

Maternal CM is significantly associated with offspring hospital and ED use, particularly for injuries and deliberate self-harm, highlighting intergenerational health risks. Routine identification and targeted support for families affected by CM may help break cycles of adversity and reduce preventable health service burden.