title: Trauma in infants less than three months of age.
abstract: We evaluated the characteristics of traumatic injury and risk for subsequent trauma in infants less than three months of age (n = 111). Medical records were reviewed at presentation and one year later. Injury was due to abuse/neglect in 28%, whereas 72% were accidentally injured. Falls were the most common mechanism of accidental injury (67%). The percentage of infants with skull fractures was greater in the abuse/neglect group than in the accidental group (7/31 vs 7/80; P < 0.05) with a tendancy toward more diastatic and multiple skull fractures (6/7 vs 2/7) as well as intracranial hemorrhages (3/7 vs 0/7). More infants in the abuse/neglect group suffered extremity fractures (4/31 vs 2/80; P < 0.05). Hospitalization was more frequent (12/31 vs 8/80; P < 0.001), as was social or protective service intervention (25/31 vs 17/80; P < 0.001), in the abuse/neglect group. The two groups showed no difference in the number of previous emergency department (ED) visits; however, the use of the ED declined significantly in the abuse/neglect group following the trauma (0.81 +/- 1.2 vs 1.5 +/- 2.1 visits; P < 0.05). The abuse/neglect group tended to have a greater number of subsequent traumatic injuries than those accidentally injured. Abuse/neglect should be considered in any seriously injured infant less than three months of age because of the likelihood of subsequent trauma.
authors.affiliation: Department of Pediatrics, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit 48201.
authors.forename: G
authors.initials: G
authors.lastname: Stewart
authors.forename: K
authors.initials: K
authors.lastname: Meert
authors.forename: N
authors.initials: N
authors.lastname: Rosenberg
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data; D000367:Age Factors; D002649:Child Abuse / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008824:Michigan / Q000453:epidemiology; D012008:Recurrence; D012887:Skull Fractures / Q000453:epidemiology / Q000209:etiology; D014947:Wounds and Injuries / Q000453:epidemiology / Q000209:etiology*