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Abusive Head Trauma in Infants During the COVID-19 Pandemic in the Paris Metropolitan Area.
Lãzãrescu, Alina-Marilena; Benichi, Sandro; Blauwblomme, Thomas; Beccaria, Kévin; Bourgeois, Marie; Roux, Charles-Joris; Vergnaud, Estelle; Montmayeur, Juliette; Meyer, Philippe; Cohen, Jérémie F; Chalumeau, Martin; Blangis, Flora; Orliaguet, Gilles.
  • Lãzãrescu AM; Department of Pediatric Anesthesia and Intensive Care, Assistance Publique-Hôpitaux de Paris, Necker-Enfants Malades Hospital, Université Paris Cité, Paris, France.
  • Benichi S; Department of Pediatric Neurosurgery, Assistance Publique-Hôpitaux de Paris, Necker-Enfants Malades Hospital, Université Paris Cité, Paris, France.
  • Blauwblomme T; Department of Pediatric Neurosurgery, Assistance Publique-Hôpitaux de Paris, Necker-Enfants Malades Hospital, Université Paris Cité, Paris, France.
  • Beccaria K; Department of Pediatric Neurosurgery, Assistance Publique-Hôpitaux de Paris, Necker-Enfants Malades Hospital, Université Paris Cité, Paris, France.
  • Bourgeois M; Department of Pediatric Neurosurgery, Assistance Publique-Hôpitaux de Paris, Necker-Enfants Malades Hospital, Université Paris Cité, Paris, France.
  • Roux CJ; Department of Pediatric Radiology, Assistance Publique-Hôpitaux de Paris, Necker-Enfants Malades Hospital, Université Paris Cité, Paris, France.
  • Vergnaud E; Department of Pediatric Anesthesia and Intensive Care, Assistance Publique-Hôpitaux de Paris, Necker-Enfants Malades Hospital, Université Paris Cité, Paris, France.
  • Montmayeur J; Department of Pediatric Anesthesia and Intensive Care, Assistance Publique-Hôpitaux de Paris, Necker-Enfants Malades Hospital, Université Paris Cité, Paris, France.
  • Meyer P; Department of Pediatric Anesthesia and Intensive Care, Assistance Publique-Hôpitaux de Paris, Necker-Enfants Malades Hospital, Université Paris Cité, Paris, France.
  • Cohen JF; Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Centre of Research in Epidemiology and Statistics, Université Paris Cité, Institut National de la Santé et de la Recherche Medicale, Paris, France.
  • Chalumeau M; Child Protection Unit, Department of General Pediatrics and Pediatric Infectious Diseases, Assistance Publique-Hôpitaux de Paris, Necker-Enfants Malades Hospital, Université Paris Cité, Paris, France.
  • Blangis F; Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Centre of Research in Epidemiology and Statistics, Université Paris Cité, Institut National de la Santé et de la Recherche Medicale, Paris, France.
  • Orliaguet G; Child Protection Unit, Department of General Pediatrics and Pediatric Infectious Diseases, Assistance Publique-Hôpitaux de Paris, Necker-Enfants Malades Hospital, Université Paris Cité, Paris, France.
JAMA Netw Open ; 5(8): e2226182, 2022 08 01.
Article in English | MEDLINE | ID: covidwho-2013229
ABSTRACT
Importance The COVID-19 pandemic and the containment and mitigation measures taken were feared to be associated with increased child abuse.

Objective:

To investigate the trend of abusive head trauma (AHT) incidence and severity in infants during the COVID-19 pandemic. Design, Setting, and

Participants:

In a time-series analysis of a longitudinal, population-based, cohort study, all consecutive cases of AHT in infants younger than 12 months old referred between January 2017 and December 2021 to Necker Hospital for Sick Children, the single regional pediatric neurosurgery center for the Paris metropolitan area, were included. AHT was defined as 1 or more subdural hemorrhage and a positive multidisciplinary evaluation after a social, clinical, biological, and radiological workup. Data were analyzed from January to March 2022. Main Outcomes and

Measures:

The primary outcome was the monthly incidence of AHT, which was analyzed using Poisson regression modeling. Secondary outcomes included mortality and severe morbidity and were studied with logistic and linear regressions. The monthly incidence of neurosurgical interventions for hydrocephalus was used as a control series.

Results:

Among the 99 included infants with AHT (median [IQR] age, 4 [3-6] months; 64 boys [65%]), 86 of 99 (87%) had bridging vein thrombosis, 74 of 99 (75%) had retinal hemorrhages, 23 of 72 (32%) had fractures, 26 of 99 (26%) had status epilepticus, 20 of 99 (20%) had skin injuries, 53 of 99 (54%) underwent neurosurgical interventions, and 13 of 99 (13%) died. Compared with the prepandemic period (2017-2019), AHT incidence was stable in 2020 (adjusted incidence rate ratio, 1.02; 95% CI, 0.59-1.77) and then significantly increased in 2021 (adjusted incidence rate ratio, 1.92; 95% CI, 1.23-2.99). The severity of AHT worsened in 2021 in terms of mortality (odds ratio 9.39; 95% CI, 1.88-47.00). Other secondary outcomes and the control series were not significantly modified. Conclusions and Relevance In this cohort study, a marked increase in AHT incidence and severity occurred during the COVID-19 pandemic in the Paris metropolitan area. These results suggest the need for clinical awareness and preventive actions.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Child Abuse / COVID-19 / Craniocerebral Trauma Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Female / Humans / Infant / Male Country/Region as subject: Europa Language: English Journal: JAMA Netw Open Year: 2022 Document Type: Article Affiliation country: Jamanetworkopen.2022.26182

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Child Abuse / COVID-19 / Craniocerebral Trauma Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Female / Humans / Infant / Male Country/Region as subject: Europa Language: English Journal: JAMA Netw Open Year: 2022 Document Type: Article Affiliation country: Jamanetworkopen.2022.26182