Abusive Head Trauma at a Tertiary Care Children's Hospital in Mexico City. A Preliminary Study

Autor/inn/en	Diaz-Olavarrieta, Claudia; Garcia-Pina, Corina A.; Loredo-Abdala, Arturo; Paz, Francisco; Garcia, Sandra G.; Schilmann, Astrid
Titel	Abusive Head Trauma at a Tertiary Care Children's Hospital in Mexico City. A Preliminary Study
Quelle	In: Child Abuse & Neglect: The International Journal, 35 (2011) 11, S.915-923 (9 Seiten) PDF als Volltext Verfügbarkeit
Sprache	englisch
Dokumenttyp	gedruckt; online; Zeitschriftenaufsatz
ISSN	0145-2134
DOI	10.1016/j.chiabu.2011.05.017
Schlagwörter	Prenatal Care; Child Abuse; Mothers; Hospitals; Head Injuries; Alcohol Abuse; Pregnancy; Infants; Adolescents; Brain; Incidence; Foreign Countries; Symptoms (Individual Disorders); Pediatrics; Young Children; Accidents; Toddlers; Comparative Analysis; Gender Differences; Age Differences; Early Parenthood; Substance Abuse; Fathers; Mexico + Suchen Sie Ihr Suchwort? Pränatale Versorgung; Abuse of children; Abuse; Child; Children; Kindesmissbrauch; Missbrauch; Kind; Kinder; Mother; Mutter; Krankengymnast; Krankenhaus; Kopfverletzung; Schwangerschaft; Infant; Toddler; Toddlers; Kleinkind; Adolescent; Adolescence; Adoleszenz; Jugend; Jugendalter; Jugendlicher; Gehirn; Vorkommen; Ausland; Psychiatrische Symptomatik; Klinische Sozialpädiatrie; Frühe Kindheit; Infants; Geschlechterkonflikt; Age; Difference; Age difference; Altersunterschied; Drug use; Drug consomption; Drogenkonsum; Mexiko
Abstract	Objectives: Determine the prevalence, clinical signs and symptoms, and demographic and family characteristics of children attending a tertiary care hospital in Mexico City, Mexico, to illustrate the characteristics of abusive head trauma among this population. Methods: This is a cross-sectional descriptive study of infants and children under 5, who suffered head trauma and were admitted to the National Pediatrics Institute in Mexico City, a tertiary care referral center. We reviewed medical records and extracted data on clinical and neurological signs and symptoms, fundus, radiological (long bones, thorax, CAT scan), and laboratory tests. We administered a standardized questionnaire assessing child abuse and neglect to the parents of the children included in the study. Results: One hundred and twenty children, under 5 presenting with head trauma, were recruited, 13 (11%) were considered abusive head trauma (AbHT) and 107 (89%) were diagnosed as accidental head injury (AcHI). The AbHT group comprised younger infants (mean age 8 months) and the AcHI group included toddlers about an average of 25 months. To account for this significant age difference, we performed a comparison of age matched cases. The children in the AbHT were more likely to be female, the result of the first unintended pregnancy and the children of younger mothers (17-19). Mothers in this group had attended fewer than 5 prenatal care visits and fathers had a history of alcohol abuse. Five (38%) of the 13 AbHT children did not survive their injuries and overall showed greater neurological and respiratory compromise, increased prothrombin time (PT), and lower hematocrit values. The most common intracranial injuries suffered by children in the AbHT group were subdural/epidural hematoma and parenchymal/subarachnoid hemorrhage. Retinal hemorrhage was the most frequent ocular injury. Conclusions: In a tertiary care children's hospital, 11% of the children presenting with head trauma, were considered of abusive origin. Unintended pregnancy among teen mothers and substance abuse in the father were associated with abusive head trauma in this descriptive study. (Contains 5 tables.) (As Provided).
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Erfasst von	ERIC (Education Resources Information Center), Washington, DC
Update	2017/4/10