UTHeath study: Children with specific birth defects at increased risk for abuse

December 10, 2015

HOUSTON - (Dec. 10, 2015) - Children born with cleft lip or palate and spina bifida are at an increased risk for abuse before the age of 2, according to researchers from The University of Texas Health Science Center at Houston (UTHealth).The results were published in the December issue of the journal Pediatrics.

In the study, researchers found that compared to children without birth defects the risk of maltreatment in children with cleft lip and/or palate was increased by 40 percent and for children with spina bifida, the risk was increased by 58 percent. These rates were especially high during the first year of life. However, children with Down syndrome were not at an increased risk compared to children with no birth defects.

"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.

Cleft lip and cleft palate are birth defects that occur when a baby's lip or mouth do not form properly during pregnancy. A baby can have a cleft lip, a cleft palate, or both a cleft lip and cleft palate. Spina bifida is a neural tube defect that affects the spine and is usually apparent at birth. Children with spina bifida have physical impairments ranging from mild to severe depending where on the spine the opening is located.

The researchers drew data from several sources from 2002 to 2011: 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.

In Texas, maltreatment is defined as neglectful supervision, physical abuse, physical neglect, medical neglect, sexual abuse, abandonment, emotional abuse or refusal to assume parental responsibility.

Among children with substantiated 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, according to Van Horne.

Researchers also studied how family factors affected risk of abuse. Children were more likely to be abused or neglected if their mothers had less than a high school education, had more children and used Medicaid. This was true even if a child did not have a birth defect. Van Horne said that poverty was likely the main factor in this finding.

"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," said Van Horne.
-end-
Karen B. Moffitt, M.P.H., Mark A. Canfield, Ph.D., and Amy P. Case, Ph.D., from the Birth Defects Epidemiology and Surveillance Branch of the Texas Department of State Health Services were study co-authors, as was Christopher Greeley, M.D., a former faculty member at UTHealth, who is now with Texas Children's Hospital. Co-authors from the School of Public Health included Robert Morgan, Ph.D., and Laura E. Mitchell, Ph.D.

The study, titled 'Maltreatment of Children under Age 2 with Specific Birth Defects: A Population-Based Study,' was funded through a cooperative agreement (#5U01DD000494-04) between the Centers for Disease Control and Prevention and the Texas Department of State Health Services, as well as through funding from the Title V Block Grant at the Texas Department of State Health Services.

University of Texas Health Science Center at Houston

Related Birth Defects Articles from Brightsurf:

Assessing cancer diagnosis in children with birth defects
In this study, led by Baylor College of Medicine and Texas Children's Hospital, researchers provide a better understanding of cancer risk in children with birth defects.

Some antibiotics prescribed during pregnancy linked with birth defects
Children of mothers prescribed macrolide antibiotics during early pregnancy are at an increased risk of major birth defects, particularly heart defects, compared with children of mothers prescribed penicillin, finds a study published by The BMJ today.

Weight-loss surgery cuts risk of birth defects
Children born to women who underwent gastric bypass surgery before becoming pregnant had a lower risk of major birth defects than children born to women who had severe obesity at the start of their pregnancy.

Defective cilia linked to heart valve birth defects
Bicuspid aortic valve (BAV), the most common heart valve birth defect, is associated with genetic variation in human primary cilia during heart valve development, report Medical University of South Carolina researchers in Circulation.

Findings shed new light on why Zika causes birth defects in some pregnancies
A new study shows that the risk of giving birth to a child with microcephaly might be related to how the immune system reacts against the Zika virus -- specifically what kind of antibodies it produces.

Severe air pollution can cause birth defects, deaths
In a comprehensive study, researchers from Texas A&M University have determined that harmful particulate matter in the atmosphere can produce birth defects and even fatalities during pregnancy using the animal model.

Famous cancer-fighting gene also protects against birth defects
New research has revealed how the famous tumour suppressor gene p53 is surprisingly critical for development of the neural tube in female embryos.

Biomarkers may predict Zika-related birth defects
The highest risk of birth defects is from Zika virus infection during the first and second trimester.

After 60 years, scientists uncover how thalidomide produced birth defects
More than 60 years after the drug thalidomide caused birth defects in thousands of children whose mothers took the drug while pregnant, scientists at Dana-Farber Cancer Institute have solved a mystery that has lingered ever since the dangers of the drug first became apparent: how did the drug produce such severe fetal harm?

Antiepileptic drug induces birth defects in frogs
A common drug for treating epileptic seizures may lead to birth defects if used during pregnancy by interfering with glutamate signaling in earliest stages of nervous system development, finds a study in frogs published in JNeurosci.

Read More: Birth Defects News and Birth Defects Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.