Peer-reviewed article
Prevalence of physical abuse by caregivers toward infants aged 0-24 months: a systematic review and meta-analysis.
Keeney CL, Fairbrother N, Kitchin V, Stagg B, Fawcett EJ et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This systematic review and meta-analysis examined the prevalence of physical abuse toward infants aged 0-24 months by caregivers using data from anonymous self-report studies across 20 studies involving over 220,000 caregivers. The pooled prevalence of at least one form of abuse was approximately 4.8%, though estimates ranged widely depending on the type of abuse, from less than 3% for severe forms like shaking to 20.5% for wrist slapping. The findings indicate that many infants experience violent caregiving practices in their first two years, but most abuse likely remains unreported and hidden from official statistics. The authors highlight the urgent need for prevention strategies.
Key points
- Approximately 1 in 20 infants in a typical sample experiences physical abuse by caregivers
- Prevalence estimates varied significantly by abuse type, from <3% for severe forms to 9.5% for spanking and 20.5-21% for wrist slapping
- 20 studies spanning North America, Europe, and East Asia were included, with over 220,000 caregivers
- Large gap exists between self-reported and official abuse statistics, indicating most infant abuse remains hidden
- Wide heterogeneity in estimates suggests prevalence varies substantially across populations and regions
Limitations
The review relies on anonymous self-report studies, which may underestimate prevalence due to social desirability bias and reluctance to disclose abuse. Definitions and types of abuse vary across studies, and cultural differences in what constitutes acceptable discipline make cross-study comparisons challenging.
Abstract
Background Although the prevalence of physical abuse in childhood is well studied, the extent among infants-a period of high vulnerability-remains poorly characterized. We aimed to estimate the prevalence of physical abuse of infants (<24 months) by caregivers, using data from anonymous self-report studies. Methods A systematic review and meta-analysis were conducted following the Cochrane Handbook. We searched MEDLINE, Embase, PsycINFO, CINAHL, and Web of Science (inception to Sep 3rd, 2025) for studies anonymously reporting the prevalence of physical abuse toward infants (0-24 months) by primary caregivers. Two reviewers independently screened studies and assessed risk of bias using the Joanna Briggs Critical Appraisal tool for prevalence studies. Prevalence estimates were aggregated using Bayesian multilevel logistic regression and heterogeneity quantified with 95% prediction intervals. The protocol was registered with PROSPERO (ID: CRD42023459469). Findings We identified 20 relevant studies (>220,000 caregivers) with prevalence estimates spread across 16 types of abuse, spanning North America, Europe, and East Asia. The pooled prevalence of reporting at least one form of abuse in a typical sample was 4·8%, 95% CI [2·6%, 7·5%] or 3·9%, 95% CI [1·9%, 6·4%] excluding "lesser" forms of abuse (e.g., spanking)-but with notable heterogeneity, 95% prediction interval [0·6%, 11·9%]. Aggregate estimates ranged from <3% for severe forms of abuse (e.g., shaking, hitting) to 9·5% for spanking or 20·5%-21·0% for slapping on the wrist (which might be culturally sanctioned in some areas). Interpretation Approximately one in twenty infants in a typical sample worldwide experience physical abuse by caregivers, though estimates vary and are likely underreported. Even in the first two years of life, many children face violent caregiving practices, pointing to an urgent need for prevention. The large gap between self-reports and official statistics highlights that most infant abuse remains hidden. Funding No funding was received for this research.