Smoking and medication during pregnancy predict repeated unintentional injuries in early childhood but not single unintentional injuries.

This study investigates prospectively the development of single and repeated unintentional injuries from birth to 42 months in a random population sample of new-born children in Quebec (Canada) (N = 1,770). The outcome measures are single unintentional injuries (SUI) and repeated unintentional injuries (RUI). Results showed that the risk factors for SUI differed from the risk factors for RUI. SUI was predicted by mother's antisocial behavior during high school (OR = 1.72) and mother's age at first birth (OR = 1.82) with children from older mothers at higher likelihood of SUI. Also, boys (OR = 1.36) and hyperactive children (OR = 1.06) were at increased risk of SUI. RUI was predicted by maternal smoking during pregnancy (OR = 1.68), medication on prescription (OR = 1.53) and medication without prescription (OR = 1.54). Boys (OR = 2.01), children with a difficult temperament (OR = 1.13) and those with single mothers had higher rates of RUI (OR = 2.05). Maternal perception of impact (OR = 1.15) and maternal feelings of self-efficacy (OR = 0.87; marginally significant) were also associated with RUI. These results show that maternal and child risk factors identified during pregnancy and just after birth can predict SUI as well as RUI in early childhood. However, the only common risk factor for SUI and RUI is the child's sex, with boys being at higher risk than girls. Implications of these findings and suggestions for prevention are discussed.