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Prevalence of Abuse-Specific Injuries in Infants With Prior Injury Evaluated for Abuse

Nara Cho1, Kristin G Crichton1, Sara Helwig2,3

  • 1The Center for Family Safety and Healing, Nationwide Children's Hospital, Columbus, Ohio; The Ohio State University College of Medicine, Department of Pediatrics, Columbus, Ohio.

Pediatrics Open Science
|January 28, 2026
PubMed

Insights

Infants with a history of prior injury are more likely to have abuse-specific injuries identified during evaluation for suspected physical abuse. This highlights the need for thorough assessments in these vulnerable infants.

Area of Science:

  • Pediatrics
  • Child Abuse Pediatrics
  • Forensic Medicine

Background:

  • Physical abuse is a significant cause of infant morbidity, often underdiagnosed in cases with minor injuries.
  • Underdiagnosis increases the risk of recurrent and escalating violence against infants.

Purpose of the Study:

  • To compare the prevalence of abuse-specific injuries in infants with and without a history of prior injury.
  • To identify risk factors associated with the identification of abuse-specific injuries.

Main Methods:

  • Retrospective, multicenter study of infants (<12 months) evaluated for suspected physical abuse.
  • Comparison of injury identification rates between infants with and without prior injury history.
  • Logistic regression analysis to assess the association between prior injury and abuse-specific injury identification.

Main Results:

  • 13% of 2352 infants had a history of prior injury.
  • Infants with prior injury showed significantly higher rates of abuse-specific injury identification (45% vs 22%).
  • Prior injury was associated with 2.81 times higher odds of identifying abuse-specific injuries.

Conclusions:

  • Infants with prior injury undergoing evaluation for suspected physical abuse have a higher likelihood of identified abuse-specific injuries.
  • Standardized history taking and comprehensive evaluation are crucial for infants presenting with concerning injuries.
Abstract

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