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Infant abusive head trauma in a military cohort
Gia R Gumbs1, Heather T Keenan, Carter J Sevick
1Naval Health Research Center, Deployment Health Research Department, 140 Sylvester Rd, San Diego, CA 92106-3521. gia.gumbs@med.navy.mil.
Insights
Abusive head trauma (AHT) rates in infants born to military families are similar to civilian rates. Key risk factors include male sex, prematurity, birth defects, young maternal age, and lower military pay grade.
Area of Science:
- Pediatric Medicine
- Public Health
- Military Health Systems
Background:
- Abusive head trauma (AHT) is a significant cause of infant mortality and morbidity.
- Understanding AHT rates and risk factors within specific populations, like military families, is crucial for targeted prevention.
Purpose of the Study:
- To determine the incidence of AHT among infants born to US military families.
- To identify risk factors associated with AHT in this population.
- To compare military AHT rates with those in the civilian population.
Main Methods:
- Utilized electronic International Classification of Diseases data from the US Department of Defense (DoD) Birth and Infant Health Registry (1998-2005).
- Included infants born to military families (N = 676,827) meeting the study's AHT definition.
- Compared military rates to civilian rates using an alternate AHT case definition.
Main Results:
- The estimated substantiated military AHT rate was 34.0 per 100,000 live births (study definition).
- Using an alternate definition, the AHT rate was 25.6 per 100,000 live births.
- Infant risk factors: male sex, prematurity, major birth defects. Parental risk factors: young maternal age, lower sponsor rank, current maternal military service.
Conclusions:
- Military AHT rates are comparable to civilian rates when using consistent case definitions.
- Infants at highest risk include those with parents in lower military pay grades, military mothers, premature infants, and those with birth defects.
- Findings highlight the need for tailored military family support programs to address AHT prevention.
Objective:
Evaluate the rate of, and risk factors for, abusive head trauma (AHT) among infants born to military families and compare with civilian population rates.
Methods:
Electronic International Classification of Diseases data from the US Department of Defense (DoD) Birth and Infant Health Registry were used to identify infants born to military families from 1998 through 2005 (N = 676 827) who met the study definition for AHT. DoD Family Advocacy Program data were used to identify infants with substantiated reports of abuse. Rates within the military were compared with civilian population rates by applying an alternate AHT case definition used in a civilian study.
Results:
Applying the study definition, the estimated rate of substantiated military AHT was 34.0 cases in the first year of life per 100 000 live births. Using the alternate case definition, the estimated AHT rate was 25.6 cases per 100 000 live births. Infant risk factors for AHT included male sex, premature birth, and a diagnosed major birth defect. Parental risk factors included young maternal age (<21 years), lower sponsor rank or pay grade, and current maternal military service.
Conclusions:
This is the first large database study of AHT with the ability to link investigative results to cases. Overall rates of AHT were consistent with civilian populations when using the same case definition codes. Infants most at risk, warranting special attention from military family support programs, include infants with parents in lower military pay grades, infants with military mothers, and infants born premature or with birth defects.
