Pre- and perinatal risk and physical abuse

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Abstract
Ecological models and research suggest that abnormal perinatal events and handicapping conditions predispose children to later physical abuse. However, results of prospective studies do not suggest that low birth weight, prematurity or perinatal problems are risk factors. A number of studies have compared abused children with siblings, thus controlling for parental factors, but the results are inconclusive. This article reviews the literature and presents the results of a retrospective study of relevant risk factors using both between and within family methods. Subjects were 87 abusive and 87 control families matched for social class, race, and child age and gender. Within the abuse group, 54 children had siblings for whom comparative data were available. Comparisons were made for 38 variables. Prenatal measures included prenatal care, complications, and maternal hospitalizations and physical problems. There were no significant differences between index children and their siblings. The only difference between abuse and control groups was for maternal hospitalizations, which were greater among the control sample. Delivery and neonatal variables included birth weight, gestation length, duration of hospital stay, birth defects or injuries, delivery complications, etc. There were no abuse control group differences. The only index-sibling difference was for birth weight (abused children were lower). Health and behaviour problems in the first year of life were also examined. The only significant difference on the eight variables was for increased hospitalization in the index children compared with siblings (29 per cent vs 8 per cent). These results are discussed in comparison with the conflicting findings of other studies, concerning the relationship of pre- and perinatal factors and infant health to subsequent physical abuse. Generally, few relationships were found, suggesting that early child factors do not play a major part as causes or correlates of child abuse.

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