Abuse, Injury More Likely When Child is With Male Caregiver: Study

Young children are far more likely to suffer abuse-related injuries when left in the care of a man, versus a woman. And those injuries are likely to be more severe, a new study finds.

The study included more than 1,600 children under age 4 who were seen for injuries at a pediatric emergency department. Of those, 24% were found to have been physically abused.

Nearly 80% of the severe injuries were classified as abuse, and nearly all cases of severe injury in which fathers and boyfriends were present involved abuse.

The likelihood of abuse-related injury was especially high when the male was the boyfriend of the mother or another caregiver, the researchers found.

"Given that we found strong associations between certain caregiver features and the likelihood of abuse, it is vitally important for clinicians evaluating the child to ask about who was present at the time of injury," said study author Dr. Mary Clyde Pierce. She's an emergency doctor at Ann & Robert H. Lurie Children's Hospital of Chicago.

Abuse-related injury was much less likely when a female caregiver was present, with the exception of a female babysitter, the findings showed.

The researchers also linked different-than-usual caregiving arrangements with increased risk of abuse.

The findings may help prevent abuse and improve early recognition of it, the study authors said in the report published June 26 in The Journal of Pediatrics.

"Through a better understanding of caregiver features, screening for child abuse can be refined, evidence-informed clinical decisions can be made, prevention efforts can be focused on populations at greatest risk, and policies can be tailored accordingly," said Pierce, who is also a professor of emergency medicine at Northwestern University Feinberg School of Medicine.

More than 1,700 children in the United States die from abuse each year, and many more suffer injuries that require hospitalization.

"Child abuse prevention efforts frequently target mothers, but our study confirms previous research that the presence of male caregivers poses a greater risk of abuse, so the focus must shift for prevention strategies to be successful," Pierce said in a hospital news release.

Those strategies should "educate parents that leaving their young children in the care of people unfamiliar with the challenges of caregiving, even for brief periods, can be dangerous," she added.

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