Birth Defects Increase Risk Of Child Abuse, Neglect

Children with certain birth defects may be at an increased risk for abuse, according to a recent study.

Researchers found that children with cleft lip were 40 percent more likely to be abused than children without a birth defect. The same was true for children with spina bifida, with a risk of 58 percent.

"A baby with Down syndrome develops just like any other baby unless they have another congenital defect. When they start missing developmental milestones is when the intellectual impairments associated with Down syndrome become more apparent. Additionally, they typically do not have the same level of medical complexity as babies with cleft lip with or without cleft palate and spina bifida, who likely have a lot of medical needs and complications. If you've just given birth and have to deal with a lot more complexity and care, it's hard," said Bethanie Van Horne, Dr.P.H., assistant director of state initiatives at UTHealth's Children's Learning Institute. Van Horne conducted the study as part of her dissertation at UTHealth School of Public Health, in a news release. 

During the study, researchers examined data from several sources between 2002 to 2001, including birth and death records from the Texas Department of State Health Services Vital Statistics Unit surveillance of children born with birth defects from the Texas Birth Defects Registry and child maltreatment information from the Texas Department of Family and Protective Services.

Maltreatment in Texas is defined as neglectful supervision, physical neglect, physical abuse, sexual abuse, medical neglect, emotional abuse, abandonment or refusal to assume parental responsibility, according to researchers. 

Findings further showed that among children who endured sustained abuse, the risk of medical neglect was three to six times higher among all three birth defect groups than in the unaffected group. The complexity of their medical conditions may be a contributing factor for the increased risk of medical neglect versus other forms of neglect.

Factors associated with an increased risk of abuse or neglect included if the mothers involved did not complete their high school education, had more children or used Medicaid--and this was true even if the child did not have a birth defect--with poverty being a main factor. 

"Physicians and medical personnel have to understand that the risk for abuse varies by specific disability. In general, when children are born with medical complexities like a birth defect, we need to be really supportive of those families. If we can identify them early and start services, we can help them understand what's to come. A lot of providers do this, but we can do more," concluded Van Horne.

The study is published in the journal Pediatrics.

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