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Baby shaken, abused before even knowing how to walk… Every year serious cases are reported in the press as well as in pediatric emergencies. For better prevention, a French team made up of doctors, pediatricians and childhood professionals examined the risk factors that recur regularly.
What is child physical abuse?
Child physical abuse (CHM) is the intentional use of physical force against a child, whether to hit, choke or shake them. When abuse occurs early, that is to say before the age of 1 year, the consequences can be formidable: neurological development disorders, mental disorders or even somatic illnesses… when it does not lead to the death of the child. the child.
But to better address the problem, the teams from the general pediatrics and infectious diseases department of the Necker-Enfants Malades AP-HP hospital, Paris Cité University, Inserm, Nantes University Hospital and the interest group EPI-PHARE scientist carried out a study to identify maternal, prenatal and postnatal factors associated with early ILD. This gave rise to a publication in the magazine The Lancet.
Prematurity, difficulty being stable… Identified risk factors
The large cohort based on exhaustive data from the national Mother-Child registry EPI-MERES, included all infants born in France between 2010 and 2019. Of the 6,897,384 infants included, 2,994 of them had a diagnosis of Early MPI, at a median age of 4 months.
The independent factors most strongly associated with early ILD were noted in mothers and reflect a difficulty in being stable, whether due to a fragile psychological state or a difficult environment:
- Low financial resources;
- An age less than 20 years old;
- An alcohol use disorder;
- Opiate use disorder;
- Being a victim of domestic violence;
- Have a chronic psychiatric pathology or chronic somatic pathology;
- A psychiatric hospitalization just before, during or after pregnancy;
Two risk factors have also been identified in infants
- Those born very prematurity;
- Those who have been diagnosed with a severe chronic neurological pathology.
Paternal factors and the causal relationship between the identified factors and ILD were, however, not explored in this study.
Better understand the flaws to better prevent
The study does not yet intend to find the solution to put an end to this tragic violence. But putting your finger on the risk factors present in France can help to understand the mechanisms of violence and to develop prevention programs, the authors hope.
“Maternal, prenatal and postnatal risk factors independently associated with early childhood physical abuse identified for the first time at the national level in France will promote a better understanding of the mechanisms of childhood physical abuse and the development of effective prevention programs. This includes the creation of risk stratification tools, thus allowing the allocation of resources to parents who may need them the most”underlines Professor Martin Chalumeau, head of the general pediatrics and infectious diseases department at the Necker-Enfants Malades AP-HP hospital.