Incidence of nonaccidental head trauma in infants: a call to revisit prevention strategies

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OBJECTIVE

Traumatic brain injury is a major sequela of nonaccidental trauma (NAT) that disproportionately affects young children and can have lasting sequelae. Considering the potentially devastating effects, many hospitals develop parent education programs to prevent NAT. Despite these efforts, NAT is still common in Western New York. The authors studied the incidence of NAT following the implementation of the Western New York Shaken Baby Syndrome Education Program in 1998.

METHODS

The authors performed a retrospective chart review of children admitted to our pediatric hospital between 1999 and 2016 with ICD-9-CM and ICD-10-CM codes for types of child abuse and intracranial hemorrhage. Data were also provided by the Safe Babies New York program, which tracks NAT in Western New York. Children with a diagnosis of abuse at 0–24 months old were included in the study. Children who suffered a genuine accidental trauma or those with insufficient corroborating evidence to support the NAT diagnosis were excluded.

RESULTS

A total of 107 children were included in the study. There was a statistically significant rise in both the incidence of NAT (p = 0.0086) and the incidence rate of NAT (p = 0.0235) during the study period. There was no significant difference in trendlines for annual NAT incidence between sexes (y-intercept p = 0.5270, slope p = 0.5263). When stratified by age and sex, each age group had a distinct and statistically significant incidence of NAT (y-intercept p = 0.0069, slope p = 0.0374).

CONCLUSIONS

Despite educational interventions targeted at preventing NAT, there is a significant rise in the trend of newly reported cases of NAT, indicating a great need for better injury prevention programming.

ABBREVIATIONS CAP = Child Abuse Potential; NAT = nonaccidental (head) trauma; SAS = Statistical Analysis Software; SBS = shaken baby syndrome; TBI = traumatic brain injury; WCHOB = Women and Children’s Hospital of Buffalo (now John R. Oishei Children’s Hospital).
Article Information

Contributor Notes

Correspondence Renée M. Reynolds: Oishei Children’s Outpatient Center (Conventus), Kaleida Health, Buffalo, NY. rreynolds@kaleidahealth.org.INCLUDE WHEN CITING Published online September 20, 2019; DOI: 10.3171/2019.7.PEDS195.Disclosures The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.
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