Impact of suspected child abuse in health outcomes in 10 years - a population- based cohort study

Abstract

Background: Child abuse includes active forms of violence against the physical and psychological integrity of the child, as well as forms of deprivation, omission, or neglect. It is a serious social problem and can lead to physical disorders such as traumatic injuries, chronic illnesses, and mental health problems. Violence against children can also compromise their development and growth, affecting them, their families, and society. This study intends to identify some complications associated with violence in children. The main goal is to analyse associated health problems in children suspected to be victims of violence, through electronic health records (EHR) analysis. Methods: A retrospective cohort study of children suspected of being victims of violence, aged from birth to eighteen years, followed at the Unidade Local de Saúde de Matosinhos (ULSM), between January 1, 2012, to December 31, 2022, using electronic health records and health registry data. Through these electronic records, we obtained data on the likelihood of health outcomes occurring in these children, 10 years after the episode of violence, namely traumatic injuries, mental disorders, somatic diseases, and health risk factors. Results: We identified 11.009 children suspected of violence, with a predominance of males (54.04%). The most prevalent health outcomes associated were fractures (24.09%), metabolic syndrome (14.92%), anxiolytic consumption (14.42%), and obesity (10.15%). In this study, the majority of children suspected of being victims of violence were at least 1.5 times more likely to have a health outcome, than other children. Stood out in the different evaluated categories: fractures (HR = 1.91, 95% CI = [1.72, 2.11]), major psychiatric disorders (HR = 3.79, 95% CI = [3.42, 4.19]), and obesity (HR = 2.00, 95% CI = [1.81, 2.21]), independent of age or sex. Conclusion: This study can infer that children who are suspected of being victims of violence are more prone to develop health outcomes associated with this episode. Most of the health outcomes examined from the categories of traumatic injuries, mental disorders, and somatic diseases were more than twice as likely to occur in this population than in a non-violent population. The likelihood of health outcomes increases with age, and the time until its emergence is shorter for children suspected of being victims of violence. These findings highlight the importance of early identification and prevention of exposure to violence in children. Our results emphasise the crucial role of health professionals in identifying and reporting situations of violence and in educating individuals about their health.