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J Med Screen. 1995;2(3):145-9.

Failure to thrive and the risk of child abuse: a prospective population survey.

Author information

  • 1Behavioural Sciences Unit, Institute of Child Health, London, United Kingdom.

Abstract

OBJECTIVE:

To identify the relative importance of failure to thrive during infancy as a risk factor for later abuse or neglect.

DESIGN:

Whole population birth cohort (1 January to 31 December 1986) studied prospectively over a four year period.

SETTING:

An inner city health district in London, England.

SUBJECTS:

2609 births, of whom 47 were identified as having non-organic failure to thrive by first birthday.

MAIN OUTCOME MEASURES:

Registration on Child Protection Register, or subject to investigation of suspected abuse or neglect without registration.

RESULTS:

2.5% (64) of birth cohort had been placed on the Child Protection Register during the period 1986-1990, and a further 1.2% (32) had been a cause for concern. The relative risk attributable to non-organic failure to thrive was 4.3 (95% CI 1.65 to 11.94) and exceeded other measured risk factors, including birth weight < 2500 g, 1.96 (95% CI 1.01 to 3.82); gestation < 35 weeks, 3.26 (95% CI 1.32 to 3.75); ordinal position > or = 4, 1.53 (95% CI 0.72 to 3.23). A multiple logistic regression confirmed the independent contribution of non-organic failure to thrive to subsequent poor parenting warranting professional intervention.

CONCLUSIONS:

Early postnatal non-organic failure to thrive is a risk factor for later serious parenting deficiencies, but previous research has overstated its importance. Within the community studied the nature of subsequent risk was (non-nutritional) neglect, rather than non-accidental injury. More than eight out of 10 cases do not give further cause for concern.

PMID:
8536184
[PubMed - indexed for MEDLINE]
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