Clinical and Epidemiological Characteristics of Suspected Child Maltreatment Reported After Caregiver Emergency Department Visits in Japan.

Aim: Child maltreatment is a major public health concern, yet identification in emergency department settings remains challenging. Caregiver-focused approaches may help identify families at risk. We describe cases reported to a hospital-based Child Protection Team following caregiver emergency department visits in Japan. Methods: We conducted a single-center retrospective observational study at an urban tertiary hospital. We included caregiver emergency department visits between January 2022 and December 2024 when the presenting adult was 18 years or older, the visit was reported to the Child Protection Team regarding at least one child under 18 years in that adult's care, and the team subsequently judged that involvement was required. We extracted medical record variables and used descriptive analyses. Results: We included 79 index caregivers and 101 emergency department visits. A documented history of mental health conditions was present in 53% of caregivers. Common diagnoses included drug intoxication, alcohol-related disorders, somatic symptom-related or dissociation-related diagnoses, injuries related to domestic violence, and self-inflicted injuries. Neglect was the most common reason for notification. Fifty-seven percent of caregivers had prior involvement with the Child Protection Team or the Council for Children Requiring Care and Support, and 30% required new registration or temporary child protection after the team review. Conclusions: This study describes a selected group of caregiver emergency department visits that were reported to a hospital-based Child Protection Team and subsequently judged to require team involvement. Further studies with defined caregiver denominators and comparison groups are needed to evaluate caregiver-focused emergency department assessment pathways.