BACKGROUND: Few research has examined the actual conditions of fatal neglect in Japan. The aims of this study are to disclose the presence of persistent neglect experiences among child fatalities using Medico-legal documents, and to describe characteristics of socio-familial background and biological data.
METHODS: The current study analyzed the documents of all postmortem external examinations and autopsies less than 2 years old performed in one prefecture in Japan from 2006 to 2011. After examining 59 autopsy cases using modified Maltreatment Classification System (MMCS), we defined sixchildrenwho experienced persistent neglect as study samples.
RESULTS: Three children were found in unsanitary room and one was left alone inside a car. In two cases, age of mother at delivery was younger than 21 years old. Three victims had 1-year older sibling in the family. As history of use in health services, three mothers did not visit enough prenatal care, and two cases refused to receive neonatal home visiting. From biological data, the average weights of six children in Z score was -2.22 after adjusted to average weight at each month age. Three children showed acute or chronic undernutritional status. Three victims had thymic involution considered as due to chronic child maltreatment.
CONCLUSIONS: The collaboration with perspectives of public health and legal medicine revealed backgrounds and biological impact through experiences of persistent neglect. The system of evaluating child death multidisciplinary is needed to identify preventable factors to intervene living neglected children appropriately.