Identifying Risk Factors of Children Who Suffered Physical Abuse: A Systematic Review.

Background: Approximately 25% of children in the United States experience child abuse or neglect, 18% of whom are physically abused. Physicians are often in a position to differentiate accidental trauma from physical child abuse. Therefore, the aim of this study was to review recent literature for risk factors associated with physical child abuse.

Methods: In this systematic review, three electronic databases were searched for articles published in the past 10 years, using the terms "abuse," "risk factors," and "children," with associated variations. A total of 1,568 articles were identified. A sequential screening process was conducted by two independent reviewers in each phase, and 63 articles were included in the final analysis. Data extraction was conducted, and a narrative synthesis was conducted.

Results: Sociodemographic risk factors of physical child abuse were younger age, male sex, African American or Hispanic race, nonprivate insurance, lower income, and lower maternal education. Other risk factors reported were previous reports of child abuse, birth defects, and developmental, musculoskeletal, intellectual, or mood disorders. Clinical and radiographic signs possibly indicative of child abuse included subdural hematoma, traumatic brain injury, retinal injury, bruising, superficial skin injury, lung injury, and fracture in skull, femur, clavicle, humerus, and foot.

Conclusion: The results of this systematic review provide insights into the potential risk factors that should be considered when assessing a child for physical abuse in the health care setting.