Child Maltreatment Among Singletons and Multiple Births in Japan: A Population-Based Study.

BACKGROUND: The occurrence of multiple births has been recognized as a risk factor for child maltreatment. However, few population-based studies have examined the relationship between multiple births and child maltreatment. This study aimed to evaluate the degree of risk of child maltreatment among singletons and multiple births in Japan and to identify factors associated with increased risk. METHODS: Using population-based data, we analyzed the database of records on child maltreatment and medical checkups for infants aged 1.5 years filed at Nishinomiya City Public Health Center between April 2007 and March 2011. To protect personal information, the data were transferred to anonymized electronic files for analysis. RESULTS: After adjusting by logistic regression for each associated factor and gestation number, multiples themselves were not associated with the risk of child maltreatment. However, compared with singletons, multiples had a significantly higher rate of risk factors for child maltreatment, including low birth weight and neural abnormality. Moreover, compared with mothers of singleton, mothers of twins had a significantly higher rate of poor health, which is a risk factor of child maltreatment. CONCLUSION: Multiples were not associated with the risk of child maltreatment. However, compared with singletons, multiples and their mothers had a significantly higher rate of risk factors of child maltreatment.

[Factors associated with the recognition of child maltreatment by mothers rearing children from infancy to primary school age].

OBJECTIVE: This research was conducted to determine the prevalence of recognition of child maltreatment among mothers with children aged 12 or under, and to identify associated factors in order to prevent child maltreatment. METHODS: The subjects of this study were 3,000 women extracted by systematic random sampling of mothers of 6,790 children who had had four-month health check-ups in Nishinomiya city. The response rate was 57.5%. After excluding mothers with children aged 13 years and over, the study sample included 1,471 mothers with children aged 12 or under. A questionnaire survey was conducted by mail. Recognition of child maltreatment by mothers was assessed with a question that asked the mother if she was sometimes aware that she had potentially abused her child, and, if yes, what kind of acts had she performed. RESULTS: There were 333 mothers (22.6%) who answered "yes" to the question "Are you sometimes aware that you have potentially abused your child?" These mothers reported emotional or physical aggression toward their children. Results of logistic regression showed that recognition of child maltreatment was associated with existence of a child whom the mother felt difficulty in cherishing, number of children, maternal poor health, higher scores of STAI trait anxiety and disabled children. Mothers reported difficulties in child-rearing for more than one child as the main reason behind existence of a child whom the mother felt difficulty in cherishing. CONCLUSION: These findings suggested that mothers with more than one child need more support in order to prevent child maltreatment.