Children with low birth weight who experience child abuse are significantly more likely to have psychiatric problems such as depression and social dysfunction in adolescence and adulthood, according to an article in the February 5 issue of the Archives of Pediatric and Adolescent Medicine.

To examine the possible combined effects of low birth weight and child abuse on adaptation and on development of psychiatric and medical problems, researchers looked at data from the John Hopkins Collaborative Perinatal Study, an epidemiologic study that followed a random sample of 1748 mothers and their children from pregnancy for more than 30 years. They compared outcomes in the transition to adulthood among four groups of children: those with low birth weight and childhood abuse, those with low birth weight alone, those with childhood abuse alone, and those with neither.

The researchers found that participants with both low birth weight and subsequent child abuse, relative to those with neither risk, were at substantially elevated risk of psychological problems: 10-fold for depression, nearly 9-fold for social dysfunction, and over 4-fold for somatization. However, the children were not at elevated risk for medical problems in adulthood.

Adults who had experienced child abuse were more likely to report delinquency, school suspension, repeating grades during adolescence and impaired well-being in adulthood, regardless of birth weight. For children with low birth weight alone, the prevalence of those problems was comparable with that of those without a risk factor.

“The number of children born with low birth weight is steadily increasing in the country,” said Yoko Nomura, PhD, MPH, Assistant Professor of Psychiatry at Mount Sinai School of Medicine and lead investigator. “These findings suggest children faced with the adversity of low birth weight and subsequent child abuse had substantially poorer outcomes than children facing either adversity alone in various areas of their life.”

“The good news is by offering preventative mental health services to mothers with low birth weight infants, and monitoring these children to provide early intervention, together we can protect such children from subsequent adversity such as abuse,” noted Claude M. Chemtob, PhD, Clinical Professor of Psychiatry and Pediatrics and one of the study investigators.