Understanding the Intergenerational Cycle of Child Protective Service Involvement.

Abstract

Adolescents in foster care have a higher pregnancy rate than those who are not in foster care. Children of adolescent mothers are also more likely to be maltreated than children of older mothers.1,2 This is perhaps one of the clearest examples of intergenerational maltreatment. The challenge is determining how to change the trajectory of the children of adolescents in foster care to decrease the unfortunate phenomenon of these children “grandchilding” into foster care. In this issue of Pediatrics , Wall-Wieler et al3 investigate the risk of foster care placement before the second birthday for children of adolescents placed in foster care during pregnancy. They do this through a data linkage of the Population Data Research Repository at the Manitoba Centre for Health Policy and physician claims, hospitalization data, and child protection information. Mothers who were ˂18 years of age and gave birth to their first child in Manitoba County over a 15-year period ending in 2013 were included. The data set included a total of 5946 mothers, of which 9.7% ( n = 576) were in foster care at the time of the birth. The investigators are to be commended for opening the door on this complex topic. We note several concerns with the study that should … Address correspondence to Rachel P. Berger, MD, MPH, Department of Pediatrics, Children’s Hospital of Pittsburgh of UPMC, 4117 Penn Ave, Pittsburgh, PA 15224. E-mail: rachel.berger{at}chp.edu