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Fatal child maltreatment associated with multiple births in Japan: nationwide data between July 2003 and March 2011
1Department of Health Science, Ishikawa Prefectural Nursing University, 1-1 Gakuendai, Kahoku, Ishikawa, 929-1210, Japan, sooki@ishikawa-nu.ac.jp.
Insights
Families with multiple births face a higher risk of fatal child maltreatment. This study highlights the increased risk per individual and per family, emphasizing the need for support.
Area of Science:
- Public Health
- Pediatrics
- Sociology
Background:
- Fatal child maltreatment remains a critical public health concern.
- Understanding risk factors is crucial for effective prevention strategies.
Purpose of the Study:
- To investigate the association between multiple births and fatal child maltreatment.
- To quantify the risk of child death due to maltreatment in families with multiple births.
Main Methods:
- Analysis of national annual reports on fatal child maltreatment in Japan (2003-2011).
- Inclusion of multiple births, teenage pregnancy, and low birth weight as exposed groups.
- Calculation of relative risks (RRs) and 95% confidence intervals (CIs), with and without missing values.
Main Results:
- 14 multiple births identified among 437 fatal child maltreatment cases.
- Elevated RRs for multiple births per individual (1.8-2.7) and per family (3.6-4.9).
- Risk associated with multiple births was lower than teenage pregnancy but higher than low birth weight.
Conclusions:
- Multiple births are associated with an increased risk of fatal child maltreatment.
- Families with multiple births require targeted support and intervention from health providers.
- Awareness of the stressors associated with multiple pregnancies/births is essential for prevention.
Objectives:
The purpose of the present study is to clarify the impact of multiple births in fatal child maltreatment (child death due to maltreatment).
Methods:
The national annual reports on fatal child maltreatment, which contain all cases from July 2003 to March 2011, published by the Ministry of Health, Labor and Welfare of Japan, were used as the initial sources of information. Parent-child murder-suicide cases were excluded from the analyses. Multiple births, teenage pregnancy and low-birthweight were regarded as the exposed groups. The relative risks (RRs) and their 95 % confidence intervals (CIs) were estimated using the data from the above reports and vital statistics. These analyses were performed both including and excluding missing values.
Results:
Among 437 fatal child maltreatment cases, 14 multiple births from 13 families were identified. The RRs of multiple births per individual were 1.8 (95 % CI 1.0-3.0) when including missing values and 2.7 (95 % CI 1.5-4.8) when excluding missing values. The RRs of multiple births per family were 3.6 (95 % CI 2.1-6.2) when including missing values and 4.9 (95 % CI 2.7-9.0) when excluding missing values. The RR tended to be much lower than the RR of teenage pregnancy (RR 12.9 or 22.2), but slightly higher than the RR of low-birthweight (RR 1.4 or 2.9).
Conclusions:
Families with multiple births had elevated risk for fatal child maltreatment both per individual and per family unit. Health providers should be aware that multiple pregnancies/births may place significant stress on families and should provide appropriate support and intervention.
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