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The epidemiology of nonaccidental trauma in children

Kishore Mulpuri1, Bronwyn L Slobogean, Stephen J Tredwell

  • 1Department of Orthopaedics, University of British Columbia, British Columbia Children's Hospital, Vancouver, BC, Canada. kmulpuri@cw.bc.ca

Clinical Orthopaedics and Related Research
|September 22, 2010
PubMed

Insights

Nonaccidental trauma (NAT) is a significant concern, with incidence rates varying widely. Younger children and parental perpetrators are key risk factors, and rib fractures are common indicators in young victims.

Area of Science:

  • Pediatrics
  • Public Health
  • Sociology

Background:

  • Child abuse, specifically nonaccidental trauma (NAT), is a prevalent societal issue with complex, often poorly understood, contributing factors.
  • Causative elements of NAT are multifactorial, involving individual, familial, and societal dynamics, with many factors not fully elucidated.

Purpose of the Study:

  • To review the general incidence of nonaccidental trauma (NAT).
  • To identify intrinsic risk factors related to the child, family, and society in NAT cases.
  • To determine common orthopaedic injuries associated with NAT.

Main Methods:

  • A comprehensive literature search was conducted using Medline, Medline In Process & Other Non-Indexed Citations, and Embase via OVID.
  • A descriptive, generalized review of NAT epidemiology was performed due to the limited number of studies meeting inclusion criteria.

Main Results:

  • The incidence of NAT spans a broad range, from 0.47 to 2000 per 100,000 individuals.
  • Younger children face a higher risk of NAT, and parental figures are frequently identified as perpetrators.
  • Rib fractures are a significant indicator of NAT in young children.

Conclusions:

  • Consideration of child, family, and societal factors is crucial when suspecting child abuse.
  • Current data on the precise incidence of NAT is limited.
  • Implementing population-based surveillance through primary care providers is recommended for more accurate incidence determination.
Abstract

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