Who's Watching the Children? Caregiver Features Associated with Physical Child Abuse versus Accidental Injury - 19/08/19
, Douglas J. Lorenz, PhD 3, 5, Kim Kaczor, MS 2, 3, Berkeley Bennett, MD, MS 7, ∗, Rachel Berger, MD, MPH 9, Melissa Currie, MD 6, Sandy Herr, MD 6, Sheila Hickey, MSW, MJ 4, Julia Magana, MD 10, 11, †, Kathi Makoroff, MD, MEd 8, Marcia Williams, MSW 12, Audrey Young, MD 2, Noel Zuckerbraun, MD, MPH 9Abstract |
Objective |
To compare caregiver features and caregiving arrangements of children with physical abuse vs accidental injuries.
Study design |
Data came from a prospective, observational, multicenter study investigating bruising and psychosocial characteristics of children younger than 4 years of age. Using logistic regression, we examined how abuse vs accidental injury and severity of injury were associated with caregiver sex, relation to the child, whether caregiving arrangements were different than usual at the time of injury, and length of the main caregiver's relationship with his/her partner.
Results |
Of 1615 patients, 24% were determined to have been physically abused. Abuse was more likely when a male caregiver was present (OR 3.31, 95% CI 2.38-4.62). When the male was the boyfriend of the mother (or another female caregiver), the odds of abuse were very high (OR 169.2, 95% CI 61.3-614.0). Severe or fatal injuries also were more likely when a male caregiver was present. In contrast, abuse was substantially less likely when a female caregiver was present (OR 0.25, 95% CI 0.17-0.37) with the exception of a female babysitter (OR 3.87, 95% CI 2.15-7.01). Caregiving arrangements that were different than usual and caregiver relationships <1 year were also associated with an increased risk of abuse.
Conclusions |
We identified caregiver features associated with physical abuse. In clinical practice, questions regarding caregiver features may improve recognition of the abused child. This information may also inform future abuse prevention strategies.
Le texte complet de cet article est disponible en PDF.Key words : parent, caregiver, physical abuse, accidents, child care
Abbreviations : GCS, MEP, PICU
Plan
| Supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD060997 [to M.P.]) and The Grainger Foundation. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Eunice Kennedy Shriver National Institute of Child Health & Human Development, the National Institutes of Health, or The Grainger Foundation. R.B. provided expert testimony related to children with concern for abuse and University of Pittsburgh Physicians (UPP) received payment. The authors declare no conflicts of interest. |
Vol 212
P. 180 - septembre 2019 Retour au numéro
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