Margaret, A.K., et al."Evaluating the Epidemiology of Inflicted Traumatic Brain Injury in Infants of U.S. Military
Families." American Journal of Preventive Medicine Volume 34, Issue 4, Supplement 1, April 2008,
Evaluating the incidence of inflicted traumatic brain injuries (inflicted TBI) in young children, and
encompassing shaken baby syndrome (SBS) and related injuries, is an epidemiologic challenge. Data
available regarding military families in the U.S. may complement other national surveillance efforts.
A protocol was developed to assess the epidemiology of inflicted TBI among infants of U.S. military
families, integrating data from the Department of Defense Birth and Infant Health Registry, healthcare
utilization databases, child abuse reporting systems, and military personnel databases. The in-progress
protocol, and its inherent strengths and limitations, are described here.
The primary strengths of data from U.S. military families are related to the full characterization
of the denominator, such that analyses are person-time and population based. Unique data are available
to describe the full population of military parents, including occupational, geographic, and socioeconomic
factors, as well as deployment-related potential stressors. The limitations of military data are similar
to many other child abuse surveillance systems in that cases are underreported and not fully characterized.
Linking abuse reports and medical utilization data to population data, however, will allow unique analyses
of “probable” and “possible” cases of inflicted TBI in infants of military families.
Data from the U.S. military, when appropriately linked and analyzed, provide opportunities to evaluate
important risk factors for inflicted TBI in infants. Although epidemiologic challenges may make incidence
rates using military data noncomparable to rates using other data sources, multivariate analyses can
evaluate critical and unique risk factors, as well as the effectiveness of prevention initiatives.