Pediatr Rev. 2022 Jul 1;43(7):361-370. doi: 10.1542/pir.2022-001271.
Infants (children <12 months of age) are maltreated at more than twice the rate of any other child age group, and infants die because of maltreatment at 3 times the rate of any other age group in childhood. The incidence of hospitalization for serious physical abuse in children also is highest for infants. Successful recognition of medically mild signs of physical abuse in infants, such as certain bruising patterns, can, therefore, lead to lifesaving interventions. The importance of the recognition of medically mild injuries due to physical abuse is underscored by the finding that a high percentage of infants (27.5%) hospitalized with serious physical abuse were found to have previously sustained milder injuries, such as bruising. Clinicians must be aware of patterns of bruising suggestive of abuse to distinguish between infants who have been abused and those who have been accidentally injured. To maximize the likelihood that abused infants will be identified and protected, as well to minimize the likelihood that an accidentally injured infant will be mischaracterized as abused, the application of an evidence-based approach to the evaluation of bruised infants should be applied. A consistent, evidence-based practice in this setting also may reduce the influence of racial and socioeconomic bias and decrease disparities in care.
婴儿（12 个月以下的儿童）受到虐待的比例是其他任何年龄段儿童的两倍多，而且婴儿因虐待而死亡的比例是儿童其他任何年龄段的三倍。儿童因严重身体虐待而住院的比例也以婴儿为最高。因此，成功识别婴儿身体虐待的医学轻度体征，如某些瘀伤模式，可以进行挽救生命的干预。由于发现有相当大比例的（27.5%）因严重身体虐待而住院的婴儿之前曾遭受过较轻的伤害，如瘀伤，因此，因身体虐待而导致的医学轻度损伤的识别重要性更加突出。临床医生必须了解提示虐待的瘀伤模式，以便区分受到虐待的婴儿和意外受伤的婴儿。为了最大限度地提高识别和保护受虐待婴儿的可能性，并最大限度地降低将意外受伤的婴儿错误定性为受虐待的可能性，应将循证方法应用于受瘀伤婴儿的评估。在这种情况下采用一致的、基于证据的实践方法也可能减少种族和社会经济偏见的影响，并减少护理方面的差异。
