Profile of hospitalised maltreated children aged 0 to 3 years and their families.

Introduction: Maltreatment adversely affects children's health and development. Knowledge of child maltreatment in early childhood is limited. We studied the demographic factors and health issues in children aged 0-3 years who were hospitalised for maltreatment.

Methods: In this retrospective cohort study, health and demographic information was extracted from the electronic medical records of children hospitalised in KK Women's and Children's Hospital between January 2018 and June 2019. High-risk groups were children with developmental delay (DD), missed vaccination (MV), low outpatient attendance, high dependency unit (HDU) or intensive care unit (ICU) admission and Child Protection Service (CPS) referral. Chi-square or Fisher's exact test was used for categorical variables. Mann-Whitney U test was used for skewed quantitative variables.

Results: Among the 101 children included in the study, the most common type of abuse and alleged perpetrator were physical abuse and parents, respectively. In addition, 35.6% of the children had pre-existing health conditions before hospitalisation, 58.4% had new health conditions diagnosed during hospitalisation requiring follow-up and 26.7% had maltreatment-related injuries. One-fifth of the children had DDs and another one-fifth had MVs. About 20% of them had defaulted all outpatient appointments. High-risk children mostly lived in rented housing. Their mothers mostly had primary education or lower. Most children admitted to ICU or HDU were <6 months old (8/12 [66.7%] vs. 6-24 months 3/12 [25%] vs. 24-47 months 1/12 [8.3%], P = 0.001). A higher number of children with DD were referred to CPS (63.2%, P = 0.049) than to other agencies.

Conclusion: Maltreated children have significant health needs that are not fully met through routine surveillance practices. They are at risk of defaulting their hospital appointment. It is imperative that families at risk of child maltreatment are identified early and their needs holistically evaluated, with care coordinated within the hospital-community support system.