Can birth trauma be confused for abuse?

Area of Science:

• Forensic Pathology
• Pediatric Autopsy
• Infant Trauma Analysis

Background:

• Unexpected infant deaths often undergo autopsy to rule out nonaccidental trauma.
• Distinguishing between inflicted injuries and birth-related trauma is critical in young infants.
• Residual birth trauma can be misidentified as signs of abuse.

Observation:

• A 4 1/2-month-old infant died unexpectedly with autopsy findings of a healing linear skull fracture.
• A circular lesion was noted on the calvarium, initially raising concerns for trauma.
• Histological findings and the overall autopsy did not support recent traumatic injury.

Findings:

• The autopsy revealed residual trauma, including a healing skull fracture and a calvarial lesion.
• Histological examination did not corroborate acute or recent nonaccidental trauma.
• Literature review supported the interpretation of findings as sequelae of birth trauma.

Implications:

• This case underscores the importance of considering birth-related injuries in the differential diagnosis of infant deaths.
• Accurate interpretation of autopsy findings is crucial to avoid misdiagnosis of nonaccidental trauma.
• Understanding birth trauma patterns can prevent misattributions of abuse in forensic investigations.