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Maltreatment more likely among kids with cleft lip, spina bifida

Children with cleft lip or spina bifida were at increased risk for maltreatment, particularly medical neglect, according to recently published data.

Researchers used linked data on nearly 3 million children, aged 4 days to 2 years, born in Texas between 2002 and 2009 to assess the correlation between specific birth defects and maltreatment, including neglectful supervision, physical or medical neglect, physical, sexual or emotional abuse and refusal to assume parental responsibility. Studied birth defects included spina bifida, Down syndrome and cleft lip with or without cleft palate.

Results demonstrated that children with cleft lip, with or without cleft palate, had a 40% increased chance of maltreatment and children with spina bifida had a 58% increased risk of any type of maltreatment, compared with children without a birth defect.  Across all four cohorts, the most common form of maltreatment was neglectful supervision, with parents being the most frequent perpetrators, according to the researchers.

Medical neglect was three to six times higher among children with birth defects, compared with unaffected children.

Children who experienced maltreatment were more likely to be premature or very premature, have a low birth weight and be a singleton or male and live in impoverished areas, according to the researchers. Additionally, children of white mothers were significantly more likely to be maltreated, compared with other ethnicities.

Children with Down syndrome had a higher risk of medical neglect compared with unaffected children, but a similar risk of maltreatment overall, according to the researchers.

The researchers noted that while there are many free or low-cost programs available for helping families with children with disabilities, these services are often not utilized.

“Increasing enrollment in existing services, as well as enhancing these services to include child maltreatment prevention strategies may prove to be an efficient and cost-effective way of preventing maltreatment in children with birth defects,” the researchers wrote. – by Casey Hower

Disclosures: The researchers report no relevant financial disclosures.