Epidemiology

Incidence is highest in the first year of age, where reported figures range from 14.7 to 39.8 per 100,000 infants.[3][4][5][6][7]​​​ These numbers are likely to be underestimated due to missed diagnoses, erroneous coding by hospitals, and milder injuries that do not present for medical care. According to the American Academy of Pediatrics, estimated incidence is at 32 to 38 cases per 100,000 in the first year, and fatal in nearly one quarter of those cases.[1]​

An analysis of national data in Taiwan from 2006 to 2015 found that the incidence of abusive head trauma was nearly 10-fold or 20-fold higher in infants <1 year (20.0 per 100,000), than in children aged 1 to 2 years (2.1 per 100,000) and 3 to 5 years (1.2 per 100,000).[7]

One comparative study in New Zealand found a marked increase in referrals for abusive head trauma in children <15 years old from 1991 to 2010, with 88 records identified in the first decade, compared with 257 in the second. The majority of children were aged <2 years.​[8]

The global incidence of abusive head trauma is difficult to elicit. Identification and diagnosis of child abuse and inflicted head injury varies drastically from country to country, often due to cultural views of what constitutes child abuse. Shaking is a common form of discipline, however, with worldwide incidence ranging from 2.6% to as high as 36% in some settings.[9]

Approximately 10% of infants die from their injuries.[10]

There is no documented ethnicity predominance.[11]

Boys sustain abusive head trauma more often than girls.[7][10]​​​​

Incidence varies by age. Cases are reported from 2 to 3 weeks of age, peak at 9 to 12 weeks, and decline to lower, stable levels by 29 to 32 weeks of age.[10][12] Cases may continue to occur until approximately age 3 years.[13] 

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