The youngsters' deaths most often resulted from a head injury, the researchers say.
The findings stem from data, submitted to 80 trauma centers nationwide, on 12,209 preschool-aged children. The kids had been admitted to hospitals for injuries sustained between April 1995 and August 1999. Of the group, 444 of the children died, according to reports from the National Pediatric Trauma Registry.
Car accidents accounted for about 30 percent of the deaths, child abuse and beatings totaled 21 percent and pedestrian injuries -- caused, for instance, by a child running into a street and being struck by a car -- reached 18 percent.
"The goal of our research was to compare the injury characteristics of hospitalized preschool children and measure those who die to those who survive," says lead researcher Dr. Mary Christine Bailey, a pediatric emergency physician at Children's Hospital in Boston. Findings were presented at a recent meeting of the Pediatric Academic Societies.
More youngsters were admitted to a trauma center after they'd fallen somehow than for any other reason -- 41 percent overall, the study says. But the death rate from falls was well below the top three causes of death.
Bailey says the figures for motor vehicle accidents likely are attributable, in part, to parents failing to buckle up their children properly.
"It's very clear from this and other studies being conducted that people are still very unaware of the importance of booster seats and protecting kids in automobiles up to age 5," she says. "I don't think that message has gotten out to the larger community as well as it should have."
While the death rate from beatings trailed motor vehicle accidents, the researchers found that child-abuse injuries were five times more likely to result in death than unintentional injuries.
The study also found that the younger the child, the more likely he or she was to die from their injuries -- regardless of the cause.
"The data holds true that, as you go down the age range, the number of deaths increases," Bailey says.
Dr. Gary Smith, director of the Center for Injury Research and Policy at Children's Hospital in Columbus, Ohio, says the high rate of death from beatings, though disturbing, isn't surprising.
"Intentional trauma to kids is more common than we would like to think," he says. "It is a leading cause of death."
Other leading causes of death among preschoolers, Smith says, include drowning, fire and suffocation.
"Drowning is a huge cause of death in the young ages," he says. "Rates tend to peak among 1- and 2-year-olds, and then later -- at around age 15 -- it comes back up again."
"Fires are a big cause because kids can't escape," he adds, "and choking and suffocation for the younger ones is another huge cause of death."
Of all the figures on causes of deaths, however, Bailey says the deaths from child abuse are perhaps the most startling.
"It's important to recognize that despite everything we've tried to do, abuse remains a significant cause of death in children," she says.
What To Do
To learn more about child safety, visit the American Academy of Pediatrics online.
And for information that could help you spot and prevent child abuse, go to Prevent Child Abuse America.