Takeo Fujiwara^1,2,3, Makiko Okuyama², Haley Tsui³ and Karestan C. Koenen⁴

¹Department of Health Promotion and Research, National Institute of Public Health, Saitama, Japan. ²Department of Psychosocial Medicine, National Center of Child Health and Development, Tokyo, Japan. ³Centre for Community Child Health Research, Child Family Research Institute, University of British Columbia. ⁴Department of Society, Human Development, and Health, Harvard School of Public Health, MA, U.S.A.

Abstract

Background:  The association between birth outcomes and child maltreatment remains controversial. The purpose of this study is to test whether infants without congenital or chronic disease who are low birth weight (LBW), preterm, or small for gestational age (SGA) are at an increased risk of being maltreated.

Methods:  A hospital-based case-control study of infants without congenital or chronic diseases who visited the National Center for Child Health and Development, Tokyo, between April 1, 2002 and March 31, 2005 was conducted. Cases (N = 35) and controls (N = 29) were compared on mean birth weight, gestational age, and z-score of birth weight.

Results:  SGA was significantly associated with infant maltreatment after adjusting for other risk factors (adjusted odds ratio: 4.45, 95% CI: 1.29–15.3). LBW and preterm births were not associated with infant maltreatment.

Conclusion:  Infants born as SGA are 4.5 times more at risk of maltreatment, even if they do not have a congenital or chronic disease. This may be because SGA infants tend to have poorer neurological development which leads them to be hard-to-soothe and places them at risk for maltreatment.

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