Youngest children from large families more at risk of breaking bones

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A new study has identified key risk factors for the likelihood of children under five breaking bones in childhood accidents.

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Youngest children and children with younger mothers were more likely to break bones

Researchers from the University of Nottingham have highlighted specific risk factors for fractures, which they say are a common and largely preventable injury.

The study concluded that children under five are more likely to fracture bones in their arms and legs if they were over one-year-old, had older brothers or sisters, had young mothers or mothers with a history of alcohol misuse.

Fractures of legs and arms were independently associated with younger maternal age and higher birth order. Children who were the fourth-born in the family, or later, are three times more at risk of fracture than first-born children.

In pre-school children two-thirds of injuries occur at home with fractures most commonly caused by falls.

The team from the University of Nottingham analysed 26,000 anonymised patient records from GPs between 1988 and 2004 and examined maternal, household and child risk factors for injury.

The data was taken from the Health Improvement Network UK primary care research database.

The authors conclude that injuries could be prevented by using this knowledge to identify families at risk and refer them to services that would put in place safety measures in the home.

Two million visits to accident and emergency departments and 120,000 hospital admissions in the UK every year are due to injuries in children aged one- to-14-years-old.

Dr Ruth Baker, from the University’s division of Epidemiology and Public Health, said, ‘I think this research shows that we can identify children most at risk of fractures by using information collected by GPs, and use this to target interventions to those families most in need as NICE recommends.’

‘It’s important that a range of measures are adopted to prevent fractures, including education for families, environmental modification and legislation. Among pre-school children, over two thirds of injuries occur within the home environment so health professionals can where appropriate refer at risk families to home safety assessment and equipment schemes, in accordance with NICE guidelines on injury prevention.’

The research paper, ‘Risk factors for long-bone fractures in children up to 5 years of age: a nested case–control study’ by Dr Ruth Baker, Dr Elizabeth Orton, Dr Laila J Tata and Professor Denise Kendrick is published online in the BMJ’s Archives of Disease in Childhood.

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