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Child deaths with persistent neglected experiences from medico‐legal documents in Japan
Author(s) -
Yamaoka Yui,
Tamiya Nanako,
Fujiwara Takeo,
Yamasaki Yukie,
Matsuzawa Akemi,
Miyaishi Satoru
Publication year - 2015
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/ped.12531
Subject(s) - medicine , neglect , pediatrics , sibling , suicide prevention , injury prevention , malnutrition , child neglect , poison control , occupational safety and health , public health , child mortality , family medicine , child abuse , psychiatry , medical emergency , environmental health , population , nursing , developmental psychology , pathology , psychology
Background Few studies have examined the actual conditions of fatal neglect in J apan. The aims of this study were to investigate persistent neglect among child fatalities using medico‐legal documents, and to describe the characteristics of the socio‐familial background and biological data. Methods The current study analyzed the documents of all postmortem external examinations and autopsies in children <2 years old carried out in one prefecture in J apan from 2006 to 2011. After examining 59 autopsy cases using modified the M altreatment C lassification S ystem, we identified six children who experienced persistent neglect as study samples. Results Three children were found in unsanitary rooms and one was left alone inside a car. In two cases, age of mother at delivery was <21 years old. Three victims had 1 year older sibling. With regard to history of use of health services, three mothers missed some prenatal care visits, and two refused to receive neonatal home visits. With regard to biological data the average weight Z score of six children was −2.22 after being adjusted to average weight for age (in months) and sex. Three children had acute or chronic undernutrition. Three victims had thymic involution considered as being due to chronic child maltreatment. Conclusions The present collaboration between public health and legal medicine has enabled investigation of the background and biological impact of experiences of persistent neglect. A multidisciplinary system of evaluating child death is needed to identify preventable factors in order to intervene in the case of neglected children in a timely manner.