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Risk factors for child abuse and neglect: Systematic review and meta-analysis
Zhidi Luo1, Yeyige Chen1, Richard A Epstein1
1Department of Psychiatry and Behavioral Sciences, Mental Health Services and Policy Program, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.
Insights
This systematic review quantifies child maltreatment risk factors. Parental mental health and substance use increase risk, while higher family income and education decrease it, informing prevention strategies.
Area of Science:
- Public Health
- Child Development
- Criminology
Background:
- Child maltreatment is a significant public health concern with severe consequences.
- Existing research on risk factors for child maltreatment lacks recent quantitative synthesis.
- Understanding these factors is crucial for developing effective interventions.
Purpose of the Study:
- To systematically identify and quantify individual, familial, community, and societal risk factors for child maltreatment.
- To analyze patterns of risk factors across different types of child maltreatment (physical, sexual, emotional abuse, neglect).
Main Methods:
- Systematic review and meta-analysis following PRISMA guidelines (2013-2023).
- Inclusion of studies on physical, sexual, emotional abuse, neglect, and multi-type maltreatment in children under 18.
- Meta-analysis using fixed and random effects models, with risk of bias, sensitivity, subgroup, and certainty of evidence (GRADE) analyses.
Main Results:
- Male children had higher odds of physical abuse (OR: 1.49).
- Protective factors included employed families, higher family education, older parental age, and higher family income (ORs 0.51-0.99).
- Risk factors included larger family size, parental mental health issues, prior maltreatment history, and substance use (ORs 1.07-5.21).
Conclusions:
- Identified risk factors operate at multiple levels (individual, familial, community).
- Findings highlight the need for targeted interventions addressing these multifaceted risk factors.
- Implications for policy, practice, and future research are crucial for enhancing child protection and well-being.
Objectives:
Child maltreatment is a major public health issue associated with adverse outcomes and societal costs, yet its risk factors lack contemporary quantitative synthesis. This review aims to identify and quantify individual, familial, community, and societal risk factors associated with different types of child maltreatment and explore patterns across maltreatment types.
Study Design:
Systematic review and meta-analysis.
Methods:
This study followed PRISMA guidelines and reviewed literature on child maltreatment from 2013 to 2023. Eligible studies focused on physical, sexual, emotional abuse, neglect, and multi-type maltreatment in children under 18. Databases used included PubMed, PsycINFO, and Web of Science. Data was extracted and analyzed using meta-analysis with fixed and random effects models. Risk of bias was assessed using the ROBINS-I tool, and sensitivity and subgroup analyses were performed. Certainty of evidence was evaluated using the GRADE approach.
Results:
Of 5554 identified studies, 42 met inclusion criteria. Significant results include: male children showed higher odds of physical abuse (OR:1.49). Employed families, higher family education, older parental age, and higher family income had lower odds of maltreatment (OR from 0.51 for income to 0.99 for parental age). Larger family size, parental mental health, maltreatment history, and substance use had higher odds of maltreatment (OR from 1.07 for family size to 5.21 for mental health). Urban areas had lower odds of physical abuse (OR: 0.88).
Conclusions:
Findings underscore the importance of addressing identified risk factors at multiple levels, with implications for practice, policy, and future research to refine prevention strategies and promote child well-being.
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