Identified spouse abuse as a risk factor for child abuse

Abstract

Context: There are limited data on the extent to which spouse abuse in a family is a risk factor for child abuse. Objective: To estimate the subsequent relative risk of child abuse in families with a report of spouse abuse compared with other families. Design: Cohort study. Setting: Analysis of a centralized US Army database Participants: Married couples with children with at least one spouse on active duty in the US Army during 1989–95. Main Outcome Measures: The US Army Family Advocacy Program’s Central Database was used to identify child and spouse abuse. The exposure was an episode of identified spouse abuse and the main outcome was a substantiated episode of subsequent child abuse. Results: During the study period of an estimated 2,019,949 person years, 14,270 incident child abuse cases were substantiated. Families with an incident case of spouse abuse identified during the study period were twice as likely to have a substantiated report of child abuse compared with other military families, rate ratio, 2.0, (95% confidence interval [CI] 1.9–2.1). Young parental age had the highest rate ratio, 4.9 (95% CI 4.5–5.3) in the subgroup analysis controlling for rank. Identified spouse abuse was associated with physical abuse of a child, rate ratio 2.4 (95% CI 2.2–2.5), and with sexual abuse of a child, rate ratio 1.5 (95% CI 1.3–1.7). Identified spouse abuse was not associated with child neglect or maltreatment, rate ratio, 1.0 (95% CI 0.9–1.1). Conclusion: An identified episode of spouse abuse in a family appears to be associated with an increased risk of subsequent child abuse and serves as an independent risk factor. Therefore, care providers should consider the potential risk to children when dealing with spouse abuse.