Runyan Desmond K
Department of Social Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-7240, USA.
Am J Prev Med. 2008 Apr;34(4 Suppl):S112-5. doi: 10.1016/j.amepre.2008.01.011.
Commentary on the methods available for ascertaining the incidence of inflicted traumatic brain injury (inflicted TBI) and the difficulties involved in defining and measuring this condition in young children.
Review of published and unpublished international data regarding parental shaking of infants compared to studies assessing incidence.
Review of parental report data reveal that the shaking of young children is a surprisingly common act in a wide variety of countries and cultures. While 2.6% of parents of children aged under 2 years in the U.S. report shaking their child as an act of "discipline," survey data from lesser-developed countries on four continents indicate that shaking, as a form of discipline, may be many times more common among infants in their countries and that the consequences, short of hospitalization or death, are inadequately studied. Methodologic challenges to epidemiologic work to develop better estimates are discussed.
These data highlight the challenges faced in ascertaining the epidemiology of inflicted TBI in young children. While there is scientific evidence that the shaking of young children can produce profound destruction of children's brains and lives, these data reveal that there are many other children who are shaken by their caregivers but escape the acute clinical presentation of "shaken baby syndrome" or for whom the injuries are not recognized as due to inflicted TBI. The impact of these private acts must be further studied as there may be other long-lasting and serious intracranial impacts that have not been characterized.
评论用于确定创伤性脑损伤（外伤性脑损伤）发病率的现有方法，以及在定义和测量幼儿这种病症时所涉及的困难。
回顾已发表和未发表的关于婴儿受父母摇晃的国际数据，并与评估发病率的研究进行比较。
对父母报告数据的回顾显示，在众多国家和文化中，摇晃幼儿是一种惊人地常见的行为。在美国，2.6%的2岁以下儿童的父母报告称曾摇晃孩子作为“管教”行为，而来自四大洲欠发达国家的调查数据表明，作为一种管教形式，摇晃在这些国家的婴儿中可能更为常见，并且除了住院或死亡之外的后果尚未得到充分研究。讨论了开展更准确估计的流行病学工作所面临的方法学挑战。
这些数据凸显了确定幼儿外伤性脑损伤流行病学所面临的挑战。虽然有科学证据表明摇晃幼儿会对儿童的大脑和生活造成严重破坏，但这些数据显示，还有许多其他幼儿被照料者摇晃，但并未出现“摇晃婴儿综合征”的急性临床表现，或者其损伤未被认定为外伤性脑损伤所致。由于可能存在其他未被描述的长期严重颅内影响，这些私下行为的影响必须进一步研究。
