Kuyvenhoven M M, Hekkink C F, Voorn T B
Vakgroep Huisartsgeneeskunde, Universitair Medisch Centrum Utrecht.
Ned Tijdschr Geneeskd. 1998 Nov 14;142(46):2515-8.
To determine the number of cases of death of children and youths (0-18 years) in 1996 in which the doctor suspected maltreatment as a possible cause of death and whether the death was declared the result of natural causes.
Questionnaire.
Department of General Practice Medicine, University of Utrecht, the Netherlands.
In co-ordination with the Dutch College of General Practitioners and in consultation with the Dutch Society of Pediatricians a questionnaire was sent to all general practitioners (n = 6957) and pediatricians (n = 971) in the Netherlands. The definition of maltreatment was left to the respondents. The questionnaire included questions regarding some characteristics of the children and the motivation of the doctor to notify or not to notify the municipal coroner. It referred to 1996 but it also asked for cases in 1992-1995 to determine whether the earlier data supported the 1996 ones.
The overall response was 83% (6583/7928). The doctors mentioned a total of 33 cases in which they suspected that the death was the result of some kind of maltreatment. 'Death from natural causes' was noted on the death certificates of 6 of these cases and the coroner was not notified. The estimated number of deaths due to mistreatment in the age group 0-18 years for 1996 was 40 (1.14 per 100,000; 95% confidence interval (95%-CI): 0.79-1.50) and 24 in the age group 0-2 years (4.13 per 100,000; 95%-CI: 2.48-5.79), with an estimate of 7 certificates stating death from natural causes.
The Dutch figures are rather similar to the minimum estimate for the United States in the youngest age groups: 4-11 cases per 100,000 and lower than for other European countries.
