Caregiver Reports of Infant Distress and Injury in Abused Infants

J Pediatr. 2022 Jun:245:190-195.e2. doi: 10.1016/j.jpeds.2022.02.056. Epub 2022 Mar 26.

Abstract

Objectives: To determine whether in infants evaluated for physical abuse, medical encounters for infant distress are correlated with physical abuse or a history of sentinel injuries.

Study design: This retrospective, case-control analysis of infants aged <12 months evaluated for physical abuse identified demographic characteristics, prior injuries, and medical encounters for infant distress. Variables were compared between abused infants and nonabused infants with and without sentinel injuries. A nonparametric recursive classification tree analysis assessed interactions between variables.

Results: Infant distress was associated with abuse (67.9% vs 44.7%; P = .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 nonsentinel injuries (18.2% vs 5.4%; P = .002) also were associated with abuse, although 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 may benefit from intensive educational and support services for their caregivers. Additional research evaluating the most effective interventions for caregivers of fussy infants is needed.

Keywords: child abuse; child maltreatment; infant crying; prevention; sentinel injury.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Caregivers*
  • Case-Control Studies
  • Child
  • Child Abuse*
  • Crying
  • Humans
  • Infant
  • Retrospective Studies