title: Child Maltreatment Among Singletons and Multiple Births in Japan: A Population-Based Study.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Public Health Nursing,Osaka City University,Osaka,Japan.
authors.forename: Yoshie
authors.initials: Y
authors.lastname: Yokoyama
authors.affiliation: Nishinomiya City Public Health Center,Nishinomiya,Japan.
authors.forename: Terumi
authors.initials: T
authors.lastname: Oda
authors.affiliation: Nishinomiya City Public Health Center,Nishinomiya,Japan.
authors.forename: Noriyo
authors.initials: N
authors.lastname: Nagai
authors.affiliation: Department of Public Health Nursing,Osaka City University,Osaka,Japan.
authors.forename: Masako
authors.initials: M
authors.lastname: Sugimoto
authors.affiliation: Nishinomiya City Public Health Center,Nishinomiya,Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Mizukami
mesh_terms: D002649:Child Abuse / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D007564:Japan; D008297:Male; D009099:Multiple Birth Offspring / Q000706:statistics & numerical data*; D018570:Risk Assessment
keywords: child maltreatment; low birth weight; maternal health condition; neural abnormality; twins