Section of Forensic Pediatrics, Department of Forensic Medicine, Netherlands Forensic Institute, the Hague, the Netherlands; Department of Radiology, Academic Medical Center/Emma Children's Hospital, Amsterdam, the Netherlands.
Acta Paediatr. 2013 Nov;102(11):e497-501. doi: 10.1111/apa.12377. Epub 2013 Aug 27.
We investigated the prevalence of risk factors for and the prevalence of prior abuse in abusive head trauma victims in the Netherlands.
We performed a retrospective file review of all abusive head trauma cases in the Netherlands in which forensic medical expertise was requested by the courts, between 2005 and 2010. Outcome measures were risk factors and indicators for prior abuse.
Eighty-nine cases were included; 62% boys, median age 3.5 months. Impact trauma was found in 48% of cases, with a male perpetrator in 79%. Prematurity, dysmaturity and twins/triplets were found in 27%, 23% and 10% of cases, respectively, maternal age under 20 years in 17%. Of the parents, 60% had completed only primary or secondary education, 38% of the families were known to child welfare authorities. There was evidence for prior abuse in 81% of the cases.
The high number of families with prior abuse indicates that both the healthcare system and child welfare authorities failed to protect some of the children that have been in their care. Our results highlight the importance of training healthcare and child welfare professionals in recognizing physical abuse, as well as the importance of optimizing abusive head trauma prevention strategies.
我们调查了荷兰虐待性头部外伤患者的风险因素流行情况和既往虐待的流行情况。
我们对 2005 年至 2010 年间荷兰所有法院要求法医专家进行的虐待性头部外伤案件进行了回顾性档案审查。结果测量指标为风险因素和既往虐待的指标。
共纳入 89 例病例；男孩占 62%，中位年龄为 3.5 个月。48%的病例发现有冲击性创伤，79%的施害者为男性。27%、23%和 10%的病例分别存在早产、发育不良和双胞胎/三胞胎，17%的母亲年龄小于 20 岁。60%的父母仅完成了小学或中学教育，38%的家庭为儿童福利机构所熟知。81%的病例有既往虐待的证据。
大量存在既往虐待的家庭表明，医疗保健系统和儿童福利机构都未能保护一些在其照护下的儿童。我们的结果强调了培训医疗保健和儿童福利专业人员识别身体虐待的重要性，以及优化虐待性头部外伤预防策略的重要性。
