Hospitalization for physical child abuse: Associated medical factors and medical history since birth

Mélanie Loiseau; Jonathan Cottenet; Irène François-Purssell; Sonia Bechraoui-Quantin; Andreas Jud; Séverine Gilard-Pioc; Catherine Quantin

doi:10.1016/j.chiabu.2023.106482

Hospitalization for physical child abuse: Associated medical factors and medical history since birth

Child Abuse Negl. 2023 Dec:146:106482. doi: 10.1016/j.chiabu.2023.106482. Epub 2023 Sep 28.

Authors

Mélanie Loiseau¹, Jonathan Cottenet², Irène François-Purssell³, Sonia Bechraoui-Quantin⁴, Andreas Jud⁵, Séverine Gilard-Pioc⁶, Catherine Quantin⁷

Affiliations

¹ Forensic Medicine Unit, University Hospital, Dijon, France; Inserm, UMR 1231, Lipides Nutrition Cancer, CHU Dijon Bourgogne, France.
² Biostatistics and Bioinformatics (DIM), University Hospital, Dijon, France.
³ Forensic Medicine Unit, University Hospital, Dijon, France.
⁴ Biostatistics and Bioinformatics (DIM), University Hospital, Dijon, France; Gynecology, Obstetrics, and Fetal Medicine, University Hospital, Dijon, France.
⁵ Child and Adolescent Psychiatry/Psychotherapy, University Hospital, Ulm, Germany, School of Social Work, Lucerne University of Applied Sciences and Arts, Switzerland; Zurich University of Applied Sciences, School of Social Work, Zurich, Switzerland.
⁶ Forensic Medicine Unit, University Hospital, Dijon, France; Cabinet d'Expertises Médicales, Belgium.
⁷ Biostatistics and Bioinformatics (DIM), University Hospital, Dijon, France; Inserm, CIC 1432, Dijon, France; Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, High-Dimensional Biostatistics 22 for Drug Safety and Genomics, CESP, Villejuif, France; Dijon University Hospital, Clinical Investigation Center, 20 Clinical Epidemiology/Clinical Trials Unit, Dijon, France. Electronic address: catherine.quantin@chu-dijon.fr.

PMID: 37776729
DOI: 10.1016/j.chiabu.2023.106482

Abstract

Background: Physical abuse often begins at a very young age and sometimes results in serious or fatal injuries. It is crucial to diagnose physical abuse as early as possible to protect this vulnerable population.

Objective: To study the factors associated with the first hospitalization for physical abuse from birth to the infant's first birthday in France.

Participants and setting: We included all singleton children born in a hospital setting in France between 2009 and 2013, who were identified from the French national information system database (SNDS).

Methods: To study factors associated with the first hospitalization for physical abuse during the first year after birth, we used the Fine and Gray regression model. Factors included in the multivariate model were the infant's sex, prematurity, neonatal conditions, the number of hospitalizations (at least two), medical consultations and complementary universal health insurance (proxy for family precariousness and socio-economic vulnerability).

Results: Over the 2009-2013 period, among 3,432,921 newborn singletons, 903 (0.026 %) were hospitalized for physical abuse in the year following birth. Among the factors associated with physical abuse, such as prematurity (aHR = 2.2[1.8-2.7]), male sex (aHR = 1.3[1.2-1.5]), or having had at least two hospitalizations (aHR = 1.7[1.4-2.1]), we found that complementary universal health insurance coverage was the factor most associated (aHR = 4.1[3.5-4.7]) with being hospitalized for physical abuse.

Conclusion: These findings could help introduce preventative measures for infant protection in certain groups, such as parents of infants born prematurely, especially if they are in a precarious situation. This study also suggests that particular attention should be paid to infants who have been hospitalized at least two times in the first year of life, whatever the reason.

Keywords: Infant physical abuse; Medical factors; Prematurity and family-precariousness.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Child
Child Abuse*
Hospitalization
Hospitals
Humans
Infant
Infant, Newborn
Infant, Premature
Male
Physical Abuse*