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Risk factors for severe burn-related injuries among children and youth: a systematic review and meta-analysis
Emilie Beaulieu1,2,3, Magali Cortenbach4, Norma Pérez Herrera5
1Reproduction, Mother and Youth Health Unit, Centre de recherche du CHU de Quebec-Universite Laval Site CHUL, Québec City, Quebec, Canada emilie.beaulieu.4@ulaval.ca.
Insights
Low socioeconomic status is the primary risk factor for severe pediatric burn injuries. Prevention strategies must address socioeconomic disparities in disadvantaged communities to reduce childhood burns.
Area of Science:
- Public Health
- Epidemiology
- Injury Prevention
Background:
- Burn injuries are a leading cause of preventable childhood death and disability globally.
- Existing research often lacks quantitative measures, hindering comparative risk assessment.
- Policymakers need robust data to prioritize effective prevention strategies for severe injuries.
Purpose of the Study:
- To systematically review and synthesize evidence on risk factors for severe and fatal unintentional pediatric burns.
- Focus on studies reporting quantitative measures of association for risk factors.
- Identify key determinants associated with severe burn injuries in children.
Main Methods:
- Systematic literature search across major databases (Medline, Embase, CINAHL, Web of Science).
- Inclusion of studies reporting risk estimates for severe (hospitalization) or fatal unintentional burns in children.
- Data extraction and risk of bias assessment using ROBINS-I; meta-analysis performed where appropriate.
Main Results:
- 25 studies involving 35,920 injuries were analyzed.
- Low neighborhood socioeconomic status was the strongest identified risk factor for severe pediatric burns.
- Male sex was also a significant risk factor; evidence for other factors was mixed and limited.
Conclusions:
- This review highlights low socioeconomic status as a critical risk factor for severe pediatric burns.
- Structural, equity-informed prevention strategies targeting disadvantaged communities are essential.
- Prioritizing interventions in vulnerable populations can effectively reduce severe pediatric burn injuries.
Background:
Burn injuries are a major cause of preventable death and disability in children worldwide. Much of the literature on risk factors has been descriptive, limiting the ability to compare risk between groups. Studies reporting quantitative measures of association can better quantify the magnitude and precision of relationships; but findings may vary across burn mechanisms and injury severity. In a context of constrained resources, policymakers require robust, comparative data to prioritise prevention strategies targeting the most serious injuries.
Objective:
To systematically review and synthesise evidence on risk factors associated with severe and fatal unintentional burn injuries among children under 20 years of age, focusing on studies reporting quantitative measures of association.
Methods:
A systematic search was conducted in Medline, Embase, CINAHL and Web of Science from inception to April 2026. Eligible studies reported risk estimates between any determinants and severe (at least hospitalisation) or fatal unintentional burn injuries in children. Two reviewers independently screened studies, extracted data and assessed risk of bias using the Risk Of Bias In Non-randomised Studies-of Exposure tool. Meta-analyses were conducted when appropriate.
Results:
25 studies (n=35 920 injuries) were included. Low neighbourhood-level socioeconomic status emerged as the strongest risk factor for severe paediatric burn injuries, followed by male sex. Evidence for other factors, including child age, maternal age, education and ethnicity, was mixed and often methodologically limited.
Conclusions:
According to this first systematic review focused on severe paediatric burn injuries, structural, equity-informed strategies targeting disadvantaged communities should be a top priority to effectively prevent severe paediatric burn injuries.
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