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A Case-Control Study to Evaluate Utah’s Shaken Baby Prevention Program

  • Heather T. Keenan
    Correspondence
    Address correspondence to Heather T. Keenan, MDCM, PhD, PO Box 581289, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah 84158.
    Affiliations
    Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah (Dr Keenan); and Department of Pediatrics, Yale University School of Medicine, New Haven, Conn (Dr Leventhal)
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  • John M. Leventhal
    Affiliations
    Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah (Dr Keenan); and Department of Pediatrics, Yale University School of Medicine, New Haven, Conn (Dr Leventhal)
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      Abstract

      Objective

      Educational programs designed to inform mothers and other child caretakers about the dangers of infant shaking have been widely adopted; however, only one has been evaluated to ascertain its effect on abusive head trauma (AHT). This project’s goal was to evaluate whether an educational video delivered on the postpartum ward decreased AHT occurrence.

      Methods

      A case-control study was conducted in which 77 Utah resident mothers of children aged under 2 years who had AHT were drawn from the only pediatric level-one trauma center in Utah and the Medical Examiner’s Office from 2001 to 2007. Five control mothers per case matched by birth year were identified through the state’s birth certificate registry. Conditional logistic regression was used to calculate the adjusted odds of AHT given maternal exposure to the educational video. An alternate injury and alternate educational exposures were assessed to examine potential confounding.

      Results

      The educational video was associated with nonstatistically significant reductions of both AHT (odds ratio [OR] 0.7, 95% confidence interval [CI], 0.5–1.2) and the alternate injury mechanism, child injury from motor vehicle crash (OR 0.9, 95% CI, 0.6–1.4). Alternate education about car seat use (OR 0.4, 95% CI, 0.2–0.8), back to sleep (OR 0.3, 95% CI, 0.2–0.5), and setting hot water temperature (OR 0.2, 95% CI, 0.1–0.4) were associated with significant reductions in AHT.

      Conclusions

      AHT occurrence was not significantly associated with the educational video but was associated with alternate postpartum education provided to mothers. These results suggest that the shaken baby prevention video is not causal at reducing AHT.

      Keywords

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