Premature birth, low birthweight raises abuse risk

Infants who are born prematurely and with a low birthweight may be at risk for child abuse, according to new research from a team of UK investigators.

"Lower levels of fetal growth and shorter gestational duration are associated with an increased likelihood of child protection registration in all categories including child sexual abuse," Professor Nick Spencer, of the University of Warwick in Coventry, and co-authors write.

The association between premature birth, low birthweight and child abuse was first reported in the 1970s, but studies have since yielded conflicting results.

The current study is unique in that it examined the association between all categories of child abuse and an infant's fetal growth and age at delivery, the researchers point out.

The findings are based on 119,771 infants, born between January 1983 and December 2001, who had data such as maternal age, birth weight and time of delivery entered into the West Sussex Child Health Computer.

These data were compared with data in the West Sussex Child Protection Register that included children who were physically, emotionally or sexually abused or neglected and were believed to be at risk for more abuse.

Unlike the other categories, however, children registered for sexual abuse did not all necessarily experience such abuse. Simply living in a household with a known offender was enough for a child to be registered for sexual abuse, the researchers note.

For all categories of abuse, rates of registration decreased as fetal growth increased, according to the report in the Journal of Epidemiology and Community Health. Similarly, the more premature the infant, the more likely he or she was to be listed on the register.

These associations were still there even after the researchers accounted for the mother's age at childbirth and socioeconomic status, the report indicates.

Spencer and his colleagues did not determine the reasons for the association, yet, they note that there are several possibilities.

"Preterm infants or those with poor fetal growth may have characteristics that make them more vulnerable to all forms of abuse," they write. These infants "may be more likely to provoke hostile parental feelings, leading to increased risk of abuse."

"Strategies and interventions aimed at preventing child abuse need to take account of the association with poor fetal growth and short gestational duration," the researchers conclude.

SOURCE: Journal of Epidemiology and Community Health, 2006.