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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
Summary
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.
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