title: Patterns of bruising in preschool children--a longitudinal study.
abstract: BACKGROUND
  This study aims to identify the prevalence and pattern of bruises in preschool children over time, and explore influential variables
  
  
  METHODS
  Prospective longitudinal study of children (<6 years) where bruises were recorded on a body chart, weekly for up to 12 weeks. The number and location of bruises were analysed according to development. Longitudinal analysis was performed using multilevel modelling.
  
  
  RESULTS
  3523 bruises recorded from 2570 data collections from 328 children (mean age 19 months); 6.7% of 1010 collections from premobile children had at least one bruise (2.2% of babies who could not roll over and 9.8% in those who could), compared with 45.6% of 478 early mobile and 78.8% of 1082 walking child collections. The most common site affected in all groups was below the knees, followed by 'facial T' and head in premobile and early mobile. The ears, neck, buttocks, genitalia and hands were rarely bruised (<1% of all collections). None of gender, season or the level of social deprivation significantly influenced bruising patterns, although having a sibling increased the mean number of bruises. There was considerable variation in the number of bruises recorded between different children which increased with developmental stage and was greater than the variation between numbers of bruises in collections from the same child over time.
  
  
  CONCLUSIONS
  These data should help clinicians understand the patterns of 'everyday bruising' and recognise children who have an unusual numbers or distribution of bruises who may need assessment for physical abuse or bleeding disorders.
authors.affiliation: Early Years Research Programme, Institute of Primary Care and Public Health, School of Medicine, Cardiff University, Cardiff, UK.
authors.forename: Alison M
authors.initials: AM
authors.lastname: Kemp
authors.affiliation: Early Years Research Programme, Institute of Primary Care and Public Health, School of Medicine, Cardiff University, Cardiff, UK.
authors.forename: Frank
authors.initials: F
authors.lastname: Dunstan
authors.affiliation: Early Years Research Programme, Institute of Primary Care and Public Health, School of Medicine, Cardiff University, Cardiff, UK.
authors.forename: Diane
authors.initials: D
authors.lastname: Nuttall
authors.affiliation: Arthur Bloom Haemophilia Centre, Institute of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK.
authors.forename: M
authors.initials: M
authors.lastname: Hamilton
authors.affiliation: Arthur Bloom Haemophilia Centre, Institute of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Collins
authors.affiliation: Early Years Research Programme, Institute of Primary Care and Public Health, School of Medicine, Cardiff University, Cardiff, UK.
authors.forename: Sabine
authors.initials: S
authors.lastname: Maguire
mesh_terms: D002649:Child Abuse / Q000706:statistics & numerical data*; D002675:Child, Preschool; D003288:Contusions / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D006113:United Kingdom / Q000453:epidemiology
keywords: Child Abuse; Injury Prevention