Risk factors for severe burn-related injuries among children and youth: a systematic review and meta-analysis
Emilie Beaulieu, Magali Cortenbach, Norma Pérez Herrera, Morgane St-Pierre Lanthier, Amélie BoutinBackground
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.