Division of Pediatric Surgery, University of Utah, Primary Children's Hospital, Suite 3800, 100 N. Mario Cappechi Dr., Salt Lake City, UT 84113, United States.
Department of Pediatric Surgery, University of Colorado School of Medicine, Children's Hospital Colorado, United States.
J Pediatr Surg. 2022 Feb;57(2):297-301. doi: 10.1016/j.jpedsurg.2021.09.050. Epub 2021 Oct 8.
Economic, social, and psychologic stressors are associated with an increased risk for abusive injuries in children. Prolonged physical proximity between adults and children under conditions of severe external stress, such as witnessed during the COVID-19 pandemic with "shelter-in-place orders", may be associated with additional increased risk for child physical abuse. We hypothesized that child physical abuse rates and associated severity of injury would increase during the early months of the pandemic as compared to the prior benchmark period.
We conducted a nine-center retrospective review of suspected child physical abuse admissions across the Western Pediatric Surgery Research Consortium. Cases were identified for the period of April 1-June 30, 2020 (COVID-19) and compared to the identical period in 2019. We collected patient demographics, injury characteristics, and outcome data.
There were no significant differences in child physical abuse cases between the time periods in the consortium as a whole or at individual hospitals. There were no differences between the study periods with regard to patient characteristics, injury types or severity, resource utilization, disposition, or mortality.
Apparent rates of new injuries related to child physical abuse did not increase early in the COVID-19 pandemic. While this may suggest that pediatric physical abuse was not impacted by pandemic restrictions and stresses, it is possible that under-reporting, under-detection, or delays in presentation of abusive injuries increased during the pandemic. Long-term follow-up of subsequent rates and severity of child abuse is needed to assess for unrecognized injuries that may have occurred.
经济、社会和心理压力与儿童虐待性伤害的风险增加有关。在严重的外部压力下，如在 COVID-19 大流行期间实施的“就地避难”令下，成年人和儿童之间长时间的身体接近，可能会导致儿童身体虐待的风险进一步增加。我们假设，与之前的基准期相比，在大流行的早期，儿童身体虐待率和相关伤害严重程度会增加。
我们对西部儿科外科研讨会的九个中心进行了疑似儿童身体虐待入院的回顾性研究。病例的时间范围为 2020 年 4 月 1 日至 6 月 30 日（COVID-19 期间），并与 2019 年同期进行了比较。我们收集了患者的人口统计学、损伤特征和结果数据。
在整个研究联合体或个别医院中，COVID-19 期间与 2019 年同期相比，儿童身体虐待病例没有显著差异。在研究期间，患者特征、损伤类型或严重程度、资源利用、处置或死亡率没有差异。
COVID-19 大流行早期，与儿童身体虐待相关的新损伤发生率似乎没有增加。虽然这可能表明儿科身体虐待没有受到大流行限制和压力的影响，但在大流行期间，虐待性损伤的报告不足、检测不足或呈现延迟的可能性增加。需要对随后的儿童虐待发生率和严重程度进行长期随访，以评估可能发生的未被识别的损伤。
