Nearly two dozen Utah children died in the past year after state child welfare authorities became involved in their cases, marking a slight increase over the year before, according to a report released Wednesday.

Four of the deaths between July 2017 and June 2018 were homicides, the report said. The others were found to be suicides, accidents or from natural causes. The 23 cases included kids ranging from newborns to 18 years old.

Any death, no matter the cause, is devastating for child welfare workers, said Ashley Sumner with the Utah Department of Human Services.

“Our case workers do the best they can with the information they have, but you can’t underestimate how difficult that is,” she said. The state opens about 20,000 child welfare cases every year.

The annual report includes children who had an open child welfare case within a year of their death. That could mean anything from an investigation into possible abuse to a foster care case. The 23 deaths reported this year mark a slight increase from the 21 reported during the same period last year, though it’s down from the 33 the year before.

The review does not detail how workers became involved, what they did, or identifying details, due to privacy concerns. Democratic Utah Sen. Gene Davis said the report this year highlights a need for workers to have strong training.

Child abuse homicide cases investigated by police in the past year have included a couple arrested in the death of 13-day-old baby who suffered severe brain injuries and a 9-year-old girl who died along with her mother in a murder-suicide.