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Bruising a significant marker for other infant injuries at autopsy.

Ingham A, Langlois N, Byard R. The significance of bruising in infants: a forensic postmortem study. Archives of Disease in Childhood, 2010; doi:10.1136/adc.2009.177469 (3 June 2010).

The presence of bruising in infants at autopsy is significantly associated with the presence of other injuries, according to a retrospective cohort study. Although inflicted trauma in children often involves the skin and subcutaneous tissues, it is not uncommon to find bruises on the limbs associated with normal non-inflicted 'wear and tear' activities, for example, on toddlers learning mobility. However, the likelihood of having a non-inflicted bruise in a child who is not independently mobile has been estimated to be <1%.

To determine the significance of bruises in cases of infant death to ascertain if their presence was associated with other injuries or homicide, all cases of infants aged between seven and 364 days who were autopsied at Forensic Science South Australia were reviewed over a nine-year period from June 1999 to May 2008. Case files including autopsy reports, photographs, and coronial and police records were reviewed. All autopsy reports were initially divided into those infants with external bruising on examination and those without external bruising.

A total of 135 infants were included in the study consisting of 83 boys and 52 girls (age range=seven to 364 days). Of these, 21 (15.6%) had one or more bruises and 114 no bruises. Of the 21 infants with bruises, 17 had other injuries or lesions (81%), with five homicides (24%), 14 aged <182 days and seven between 182 and 364 days. Bruising is a significant marker for other injuries in infants presenting to coronial autopsy, and homicide occurs more commonly in this group, conclude the authors.
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Title Annotation:CLINICAL PAPERS
Publication:Community Practitioner
Article Type:Brief article
Geographic Code:4EUUK
Date:Aug 1, 2010
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