Small birthweight and premature birth may be associated with a higher risk of child abuse and neglect, suggests research in the Journal of Epidemiology and Community Health.

The findings are based on almost 120,000 children born between 1983 and 2001, who had been placed on the child protection register of one county in south east England.

Children are placed on the register if they have already endured physical and/or emotional abuse and neglect. But the register may also include children who have not been sexually abused, but who live in a household with a registered sex offender.

How long they had been in the womb before birth (gestational age) and their weight at birth were then assessed.

The results showed that whatever the type of abuse, the lower the birthweight, the more likely it was that the child be placed on the child protection register.

Similarly, the shorter the gestational age, the greater was the likelihood of placement on the child protection register.

The association was not confined to babies born very early or very small, but was spread across the range of lower than expected birthweight and gestational age.

The findings held true even after adjusting for levels of deprivation and age of the mother at birth, both of which are known to influence the length of pregnancy and a baby’s birthweight.

The authors are quick to point out that their study was not designed to find out if low birthweight and premature birth predispose to subsequent abuse.

But they suggest that premature or small birthweight babies may have characteristics that make them more vulnerable to abuse, or possibly that they provoke greater parental hostility.

Alternatively, they suggest that premature birth and low birthweight share some as yet unidentified factor with abuse.

[Child abuse registration, fetal growth, and preterm birth: a population based study by Journal of Epidemiology and Community Health 2006; 60: 337-340]