Research in Child Abuse and Neglect: Risk Factors for Physical Child Abuse (2008)

Part of our ongoing survey of the what the child abuse and neglect literature says about perpetrators. Perpetrator data is highlighted in bold.

http://www.thieme-connect.com/ejournals/abstract/ejps/doi/10.1055/s-2008-1038922

Eur J Pediatr Surg 2008; 18: 387-391
DOI: 10.1055/s-2008-1038922

© Georg Thieme Verlag KG Stuttgart · New York

Risk Factors for Physical Child Abuse in Infants and Toddlers

T. Hurme1, S. Alanko2, P. Anttila3, T. Juven2, E. Svedström4
1 Department of Pediatric Surgery, University Hospital Turku, Turku, Finland
2 Department of Pediatric Psychiatrics, University Hospital Turku, Turku, Finland
3 Department of Pediatrics, University Hospital Turku, Turku, Finland
4 Department of Pediatric Radiology, University Hospital Turku, Turku, Finland

Abstract
Background: We examined the risk factors and injuries in physical child abuse between November 2003 and February 2007. Patients and Methods: The uptake area of the University Hospital of Turku, Finland, consists of about 700 000 inhabitants. Forty-eight cases of physical child abuse were examined. The median age of the abused children was 2.2 years, for children with skull fractures it was 0.5 years. The incidence of child physical abuse increased during the study period; it was 0.6/month in 2004 and 1.7/month in 2006. Mortality in the study group was 2.1 %.

Results: Depression, overactivity, crying and prematurity were risk factors in the physically abused children. Parental risk factors were alcohol and drug abuse. Most often the perpetrator was the father or stepfather; when the perpetrator was unknown, the children were mostly in their mothers' care. The average delay of 3 weeks until starting the investigation into abuse was mostly due to delays by health centers or homes. Radiographs were the cornerstones of the medical examination but magnetic resonance examinations were essential for the examination protocol.

Conclusions: All levels of public health services, day care facilities and schools must be aware of possible physical child abuse and initiate an investigation as soon as possible by contacting the authorities. Physically abused children and their families must be followed up and supported for a sufficiently long period by social pediatric outpatient wards. The general information on child maltreatment provided to the public needs to be increased to prevent abuse. A child welfare report must be made to social workers in every maltreatment case examined in hospital, and in most cases the offence must also be reported to the police. Nevertheless, in certain cases even permanent custody of the child cannot be avoided.