Child Maltreatment Hospitalizations: Pandemic Trends and Concerns

Hospital admissions for child maltreatment in children under the age of two decreased by 31% during the initial 16-week lockdown phase of the COVID-19 pandemic, but subsequently rose sharply, increasing by 80% after restrictions were lifted, according to research published in the Canadian Medical Association Journal .

Initial Decline and Subsequent Increase

Researchers from the Pediatric Outcomes Improvement Through Coordination of Research Networks (POPCORN) analyzed hospital admissions from March 1, 2020, to March 25, 2023, comparing them to the prepandemic period of April 3, 2016, to February 29, 2020. Data was collected from all Canadian provinces and territories except Quebec, with Quebec’s data sourced from l’Institut national d’excellence en santé et en services sociaux (INESSS). The study identified 1,518 hospital admissions for child maltreatment among approximately 750,000 children under two years old.

The initial decrease in hospitalizations during the strict public health measures—which included school closures, restricted access to primary care, and increased household stress—may not represent a true decline in the incidence of child maltreatment. Researchers suggest that milder cases may have gone undetected due to limited access to healthcare during this period.

Potential for Undetected Abuse

The subsequent increase in intensive care unit (ICU) admissions for child maltreatment raises concerns that abuse may have been occurring undetected during the period of stringent public health measures. The authors emphasize the importance of hospital admissions for identifying sentinel injuries indicative of child maltreatment, which could trigger interventions to prevent more severe outcomes.

Implications for Future Pandemic Preparedness

The study highlights the need for proactive mechanisms to identify cases of child maltreatment, even during public health restrictions. Researchers suggest that future pandemic preparedness plans should include strategies to ensure continued surveillance and support for vulnerable children, and families. A related article in the Canadian Medical Association Journal, “Sentinel injuries and indicators of child physical abuse,” provides guidance for clinicians on recognizing potential signs of abuse.