Familial factors and child characteristics as predictors of injuries in toddlers: a prospective cohort study

OBJECTIVE To identify family and child characteristics that put toddlers at risk of injuries. DESIGN A prospective cohort study. SETTING This study was based on the Norwegian Mother and Child Cohort Study, conducted by the Norwegian Institute of Public Health. PARTICIPANTS The study sample consisted of 26 087 children and their mothers. OUTCOME MEASURES Family and child characteristics measured before or at 18 months of age were investigated as potential predictors of hospital-attended injuries that occurred between 18 and 36 months of age. RESULTS In the multivariable analysis, younger maternal age (OR 0.93, 95% CI 0.86 to 1.00), financial problems (OR 1.18, 95% CI 1.01 to 1.39), maternal mental distress (OR 1.09, 95% CI 1.03 to 1.16), having older siblings (OR 1.22, 95% CI 1.08 to 1.39), increased gestational age at birth (OR 1.04, 95% CI 1.00 to 1.07) and male gender (OR 1.26, 95% CI 1.11 to 1.42) were risk factors for hospital-attended injuries. Children with impaired gross motor development had a decreased risk of injury (OR 0.65, 95% CI 0.42 to 0.99), whereas those with impaired fine motor development had an increased risk (OR 1.55, 95% CI 1.22 to 1.97). Shyness was a protective factor (OR 0.92, 95% CI 0.86 to 0.98). Children with three reported attention problems had a slightly increased risk of hospital-attended injuries (OR 1.33, 95% CI 1.02 to 1.72; p=0.035); otherwise, behaviour was not a significant risk factor. CONCLUSIONS This study demonstrated that a wide variety of factors were in play as predictors of injuries in young children. Both child-related factors (gender, gestational age at birth, child motor development, shyness and attention) and familial factors (having older siblings, maternal age, financial difficulties and maternal mental health problems) were associated with injuries in toddlers.