title: Maltreatment of Children Under Age 2 With Specific Birth Defects: A Population-Based Study.
abstract: OBJECTIVE
  Children with disabilities are at an increased risk for maltreatment. However, the risk of maltreatment is unknown for children with specific types of birth defects. This study was conducted to determine whether the risk and predictors of maltreatment differ between children with and without 3 birth defects: Down syndrome, cleft lip with/without cleft palate, and spina bifida.
  
  
  METHODS
  This population-based study of substantiated childhood maltreatment was conducted in Texas from 2002 to 2011. Linked data were used to describe the risk and types of maltreatment that occurred before age 2 years in children with and without specific birth defects. Poisson regression was used to identify predictors of maltreatment and assess differences in those predictors between children with and without these specific birth defects.
  
  
  RESULTS
  The risk of maltreatment (any type) in children with cleft lip with/without cleft palate and spina bifida was increased by 40% and 58%, respectively, compared with children with no birth defects. The risk of any maltreatment was similar between children with Down syndrome and unaffected children. Across birth defect groups, the risk of medical neglect was 3 to 6 times higher than in the unaffected group. Child-, family-, and neighborhood-level factors predicted maltreatment in children with and without birth defects.
  
  
  CONCLUSIONS
  The overall risk of substantiated maltreatment was significantly higher for some but not all birth defect groups. The factors associated with increased risk were similar across groups. Enhancement of existing maltreatment prevention and early intervention programs may be effective mechanisms to provide at-risk families additional support.
authors.affiliation: University of Texas Health Science Center at Houston Medical School, Houston, Texas; bethanie.s.carr@uth.tmc.edu.
authors.forename: Bethanie S
authors.initials: BS
authors.lastname: Van Horne
authors.affiliation: Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services; and.
authors.forename: Karen B
authors.initials: KB
authors.lastname: Moffitt
authors.affiliation: Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services; and.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Canfield
authors.affiliation: Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services; and.
authors.forename: Amy P
authors.initials: AP
authors.lastname: Case
authors.affiliation: University of Texas Health Science Center at Houston Medical School, Houston, Texas;
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Greeley
authors.affiliation: University of Texas Health Science Center at Houston School of Public Health, Houston, Texas.
authors.forename: Robert
authors.initials: R
authors.lastname: Morgan
authors.affiliation: University of Texas Health Science Center at Houston School of Public Health, Houston, Texas.
authors.forename: Laura E
authors.initials: LE
authors.lastname: Mitchell
mesh_terms: D016022:Case-Control Studies; D002649:Child Abuse / Q000706:statistics & numerical data*; D002675:Child, Preschool; D002971:Cleft Lip; D002972:Cleft Palate; D004314:Down Syndrome; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D016012:Poisson Distribution; D012044:Regression Analysis; D012307:Risk Factors; D016135:Spinal Dysraphism; D013781:Texas