Abusive Head Trauma Cases Declined During Pandemic: Pre-published Study

Hospital admissions of children under 5 diagnosed with Abusive Head Trauma (AHT) declined significantly during the COVID-19 pandemic, contradicting an expectation that child maltreatment would increase due to the emotional and economic stressors of the pandemic. That was the finding of a pre-published study, “Hospital Admissions for Abusive Head Trauma at Children’s Hospitals During COVID-19,” which is pre-published online in Pediatrics Tuesday, April 20. The study, to be published in the July 2021 Pediatrics, compared mean monthly hospital admissions for Abusive Head Trauma and key demographic and admission characteristics at 49 children’s hospitals during March–September 2020, with those across the same months of the preceding three years. About 0.1% -- or 1,317 -- of the total 1,216,336 hospitalizations for children under age 5 were for Abusive Head Trauma. Of these, 750 occurred between March 11 and September 30, 127 (16%) of which were in 2020. Compared to 2017-2019, children hospitalized with AHT during 2020 had a shorter length of stay but were otherwise similar regarding the time spent in an intensive care unit, ventilator utilization, subdural hemorrhage, retinal hemorrhage, and mortality. Early studies supported the expectation that maltreatment cases had increased but they were limited to single institutions with short study periods during the pandemic. The authors suggest one explanation could be that with the marked increase in job losses for women and many adults working from home, young children were more likely than pre-pandemic to be cared for by two or more caregivers. This would potentially reduce the likelihood of sole male caregivers who are the most common perpetrators of Abusive Head Trauma.

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