Citation

Rabbitt AL, Olson NL, Liegl MN, Simpson P, Sheets LK. J. Pediatr. 2022; ePub(ePub): ePub.

Copyright

(Copyright © 2022, Elsevier Publishing)

DOI

10.1016/j.jpeds.2022.02.056

PMID

35351533

Abstract

OBJECTIVES: To determine if, among infants evaluated for physical abuse, medical encounters for infant distress are correlated with physical abuse or a history of sentinel injuries. STUDY DESIGN: A retrospective, case control analysis of infants <12 months evaluated for physical abuse identified demographics, prior injuries, and medical encounters for infant distress. Variables were compared between abused and non-abused infants with and without sentinel injuries. A non-parametric recursive classification tree analysis assessed interactions between variables.

RESULTS: Infant distress is associated with abuse (67.9% vs 44.7%, P = 0.008; OR 2.6, 95% CI = 1.3-5.2). Infants with sentinel injuries had higher rates of infant distress (74.1% vs 42.4%, P ≤.001) and crying (81.5% vs 62.7%, P =.012). Previous falls (32.6% vs 18.1%, P =.03) and non-sentinel injuries (18.2% vs 5.4%, P =.002) were also associated with abuse, though sentinel injuries were the most important predictor of abuse followed by infant distress.

CONCLUSIONS: Infants with medical encounters for distress and injury may be at higher risk for abuse and benefit from intensive educational and support services for their caregivers. Additional research evaluating the most effective interventions for caregivers of fussy infants is needed.

Language: en

Keywords

prevention; child maltreatment; child abuse; infant crying; sentinel injury