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Underascertainment of child abuse fatalities in France : retrospective analysis of judicial data to assess underreporting of infant homicides in mortality statistics

Abstract : OBJECTIVES:Test the hypothesis of an underestimation of infant homicides in mortality statistics in France; identify its causes; examine data from the judicial system and their contribution in correcting this underestimation. METHODS:A retrospective, cross-sectional study was carried out in 26 courts in three regions of France of cases of infant deaths submitted to the courts, 1996-2000, with follow-up of their files until case closing (1996-2008). For each case, cause of death established by the courts was compared with ICD cause of death as coded in official mortality statistics. RESULTS:We examined 247 cases. Shortcomings in investigations were noted (autopsies: 75% of cases; fundus examination: 11%; diagnosis of sudden infant death syndrome [SIDS] without autopsy: 41%). Eighty deaths were considered homicides by the courts. Homicide rates in the court study are 2-3.6 times higher than those in mortality statistics. Nearly 1/3 of "accidental" deaths and 1/4 of deaths from unknown cause in mortality statistics are homicides. Mechanisms of underascertainment are: physicians' inappropriate death certification and underreporting of suspicious cases; inadequate investigation of cases; incomplete communication of final medical and forensic results to the mortality statistics department. CONCLUSIONS:In a country where neither transportation of the body to a hospital nor autopsy is obligatory, judicial data can make an important contribution to correcting mortality statistics.
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https://hal-cnrs.archives-ouvertes.fr/hal-03477292
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Submitted on : Monday, December 13, 2021 - 1:24:20 PM
Last modification on : Thursday, December 16, 2021 - 4:20:23 PM

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Anne Tursz, Monique Crost, Pascale Gerbouin-Rérolle, Jon Cook. Underascertainment of child abuse fatalities in France : retrospective analysis of judicial data to assess underreporting of infant homicides in mortality statistics. Child Abuse and Neglect, Elsevier, 2010, 34 (7), pp.534-544. ⟨10.1016/j.chiabu.2009.12.005⟩. ⟨hal-03477292⟩

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