Maternal disability and newborn discharge to social services: a population-based study
Bibliographic record
Abstract
Introduction: Removing a child from their family is the option of last resort for social services. However, decisions to place children into care are occurring more frequently and earlier in children's lives, with newborn discharge to social services being a particular concern due to the effects of mother-newborn separations on child development. Women with disabilities face negative assumptions about their parenting capacity, but little is known about their rates of newborn discharge to social services. Objectives: To examine the risk of discharge to social services among newborns of women with and without disabilities. Methods: We conducted a population-based cohort study of singleton livebirths in Ontario, Canada, 2008-2019. We used modified Poisson regression to estimate the relative risk (RR) of discharge to social services immediately after the birth hospital stay, comparing newborns of women with physical (n = 114,685), sensory (n = 38,268), intellectual/developmental (n = 2,094), and multiple disabilities (n = 8,075) to newborns of women without a disability (n = 1,221,765). Within each group, we also examined maternal sociodemographic, health, health care, and pregnancy-related characteristics associated with the outcome. Results: Compared to newborns of women without disabilities (0.2%), newborns of women with physical (0.5%; aRR 1.53, 95% CI 1.39-1.69), sensory (0.4%; aRR 1.34, 95% CI 1.12-1.59), intellectual/developmental (5.6%; aRR 5.34, 95% CI 4.36-6.53), and multiple disabilities (1.7%; aRR 3.09, 95% CI 2.56-3.72) had increased risk of being discharged to social services after the birth hospital stay. Within each group, the strongest predictors of the outcome were young maternal age, low income quintile, social assistance, maternal mental illness and substance use disorders, inadequate prenatal care, and neonatal morbidity. Conclusions: Newborns of women with disabilities are at increased risk of being discharged to social services after the birth hospital stay. These findings can be used to inform the development of tailored supports for new mothers with disabilities and their infants.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".