Analysis of child abuse cases admitted in pediatric service in Japan I. Two types of abusive process in low birth‐weight infants

Abstract

A very high rate (43.0%) of low birth‐weight (LBW) was shown in 331 abused/neglected cases reported from pediatric clinics of major hospitals in Japan. Of 87 LBW cases, 82.8% had medical problems and/or unsatisfactory reunion after non‐home care and were abused at a particular age when each of the problems may have caused difficulties in caring. Two types of processes to abuse these intractable LBW were estimated: (i) abusers with psychiatric, mental problems or poor knowledge abused their children during the first 2 years, presumably because of an inability in child rearing; and (ii) abusers with neurosis or abnormal personality abused at ages over 2 years, complained of difficulties with rearing their children, and were suspected to be unable to cope with the difficulties. In both types, a combination of child and parental problems increased at risk. Obstetricians and neonatologists, who first encounter both high‐risk mothers while pregnant and LBW, should give due care to the prevention of child abuse.

Perinatal Factors Associated with Infant Maltreatment

“…In contrast, case-control studies in the U.S. using data from children born in the 1970's showed no association between LBW and child maltreatment (21,(23)(24)(25)(26). Moreover, some have argued that the association between LBW and maltreatment can be explained by the fact that LBW infants tend to have congenital or chronic diseases, which require special care from mothers and may hinder or prevent the development of maternal attachment to the child (20,22,27,28). Little is known about whether LBW infants without congenital or chronic diseases are at risk of maltreatment.…”

“…Research-based evidence for LBW as a risk factor for child maltreatment is particularly inconsistent in the medical literature. In a nation-wide child maltreatment population study in Japan, it was reported that the percentage of maltreated children who were born as LBW was 43%, which is much higher than in the general population (5.7%) (22). In contrast, case-control studies in the U.S. using data from children born in the 1970's showed no association between LBW and child maltreatment (21,(23)(24)(25)(26).…”