Table 2.
Referral indications versus actual CSC contact
| No CSC contact n = 34,116 Frequency (%) |
With CSC contact n = 2,206 Frequency (%) |
Total pregnancy records with referral indication | Percentage of pregnancy records with identified referral indication, with CSC involvement | Unadjusted Risk Ratio (95% CI) |
p-value | |
|---|---|---|---|---|---|---|
| Previous child removed or adopted | 10 (0.03%) | 81 (3.67%) | 91 | 89.01% | 15.18 (13.88–16.59) | < 0.001 |
| Current CSC contact for older sibling(s)* | 0 | 542 (100%) | 542 | 100% | 21.50 (20.52–22.53) | < 0.001 |
| Maternal severe mental illness impacting parenting capacity○ | 86 (0.25%) | 83 (3.76%) | 169 | 49.11% | 8.36 (7.12–9.82) | < 0.001 |
| Paternal severe mental illness impacting parenting capacity+ | 22 (0.06%) | 14 (0.63%) | 36 | 38.89% | 6.43 (4.27–9.71) | < 0.001 |
| Maternal substance use | 423 (1.24%) | 140 (6.35%) | 563 | 24.87% | 4.30 (3.69–5.02) | < 0.001 |
| Paternal substance use | 686 (2.01%) | 161 (7.30%) | 841 | 19.01% | 3.29 (2.85–3.82) | < 0.001 |
| Young parent (under 16y) | 11 (0.03%) | 20 (0.91%) | 31 | 64.52% | 10.71 (8.22–13.96) | < 0.001 |
| Domestic abuse disclosure either in SLaM or Maternity | 461 (1.35%) | 386 (17.50%) | 847 | 45.57% | 8.88 (8.14–9.69) | < 0.001 |
| Learning disabilities impacting parenting capacity | 7 (0.02%) | 25 (1.13%) | 32 | 78.12% | 13.00 (10.75–15.71) | < 0.001 |
| Mother is a care leaver | 120 (0.35%) | 500 (22.71%) | 621 | 80.68% | 16.89 (15.87–17.98) | < 0.001 |
| No antenatal care | 53 (0.16%) | 12 (0.54%) | 65 | 18.46% | 3.05 (1.83–5.09) | < 0.001 |
| Denied or concealed pregnancy | 43 (0.13%) | 16 (0.73%) | 59 | 27.12% | 4.49 (2.95–6.83) | < 0.001 |
* Unadjusted risk ratio could not be estimated using Stata binreg command, in view of 100% of cases with CSC contact. For this particular referral indication, we used the Stata cs command instead. Stata binreg and cs commands gave comparable unadjusted risk ratios for other referral indications. However, the cs command does not allow for adjusting for clustering of pregnancies by mother for this referral indication
○ Maternal severe mental illness was defined as either being detained under the Mental Health Act or treated by specialist mental health teams (e.g. addiction, forensic or child and adolescent mental health services), and excluded treatment by perinatal mental health community team
+ Paternal severe mental illness was defined as schizophrenia and psychosis