Children born with low birth weight (LBW) who suffered child abuse are substantially more likely to develop psychological problems such as depression and social dysfunction in adolescence and adulthood.
The new study by Mount Sinai School of Medicine (MSSM) researchers is the first to investigate the possible interaction between LBW and later adversity. Their research findings are published in the February 5, 2007 issue of The Archives of Pediatric & Adolescent Medicine.
According to the Center for Disease Control (CDC), the percentage of infants born LBW (less than 2,500 grams) has risen 16 percent since 1990. LBW is a major public health problem in the United States, contributing substantially to both infant mortality and to childhood physical impairment.
To examine the possible conjoined effects of LBW and child abuse on adaptation and on the development of psychiatric and medical problems, researchers looked at data from the John Hopkins Collaborative Perinatal Study, an epidemiologic study that followed random sample of mothers and their children from pregnancy for more than 30 years.
They compared outcomes in the transition to adulthood among four groups of children: those with LBW and childhood abuse, those with LBW alone, those with childhood abuse alone and those with neither.
The researchers found that participants with both LBW and subsequent child abuse, relative to those with neither risk, were at a substantially elevated risk of psychological problems: a 10-fold for depression; a nearly 9-fold for social dysfunction and an over 4-fold for somatization.
However, they were not at an elevated risk for medical problems in adulthood. Those exposed to child abuse were more likely to report delinquency, school suspension, repeating grades during adolescence and impaired well-being in adulthood, regardless of LBW status. For those with LBW alone, the prevalence of those problems was comparable to that of those without either risk factor.
“The number of children born with low birth weight is steadily increasing in the country,” said Yoko Nomura, Ph.D., M.P.H, Assistant Professor of Psychiatry at Mount Sinai School of Medicine and lead investigator of this study.
” These findings suggest children faced with the adversity of low birth weight and subsequent child abuse had substantially poorer outcomes than children facing either adversity alone in various areas of their life.”
“The good news is by offering preventative mental health services to mothers with LBW, and monitoring LBW children to provide early intervention, together we can protect such children from subsequent adversity such as abuse,” noted Claude M. Chemtob, Ph.D., Clinical Professor of Psychiatry and Pediatrics and one of the study investigators.