Maternal social care experience during adolescence and their children’s early health and educational outcomes

Abstract Background One in four children in England receive children’s social care support by age 18. While these children face higher risks of poor health and educational outcomes, it remains unclear whether this disadvantage extends to their own children. Methods We used an existing linkage of administrative social care, education, and health records for mothers and their children in England (ECHILD). Using Poisson regression, we estimated adjusted risk ratios (aRRs) to compare child outcomes based on maternal social care exposure during adolescence, adjusting for maternal and child characteristics. Results Among 176,280 children born to mothers aged 17-24 in England, 31% had mothers who experienced social care between ages 11-16. Children of mothers with a social care history were more likely to have low birthweight or be born preterm: for mothers who were a child in need, aRRs were 1.11 (95% confidence interval [CI] 1.06-1.15) for low birthweight and 1.06 (95% CI 1.01-1.10) for preterm birth. These associations were stronger for mothers aged 19-24 at delivery than those aged 17-18. Children of care-experienced mothers also had a higher risk of infant mortality (aRR 1.62; 95% CI 1.17-2.19). For a subset of children followed to age five, there were no differences in school readiness between mothers with and without social care histories after adjusting for confounders. Conclusions Maternal disadvantage associated with social care involvement extends to the next generation. Targeted support for mothers with a social care history, particularly those giving birth young, is needed to prevent adverse child outcomes, including infant mortality.