May 3, 1999
Web posted at: 5:07 p.m. EDT (2103 GMT)

In this story: Risk factors vary Choking deaths common in smallest babies RELATED STORIES, SITES

From Medical Correspondent Rhonda Rowland

BETHESDA, Maryland (CNN) -- Homicide has been identified for the first time as the leading cause of death by injury in children less than 1 year old, according to a government study.

"We usually don't think of infants as being at risk of death from injuries," said Mary Overpeck, a researcher with the National Institute of Child Health and Development. "But infants between the ages of 1 month to 1 year are at highest risk of injury death than at any other time during childhood until age 15, when they start learning to drive."

Researchers looked at the birth and death certificates of more than 10,000 infants between 1983 and 1991. They found homicide, including battery, shaking and throwing the child, accounted for 23 percent of all injury deaths. The results are published in the May issue of the journal Pediatrics.

"Another 27 percent of the injury deaths were classified as 'suspicious' by medical examiners, which means more than half of these deaths could be due to homicide," Overpeck said.

Risk factors vary

Infants were more likely to die from an injury if they weighed little at birth or were premature or male.

"We also found the infants were more likely to die if their mothers began to bear children before age 17, were unmarried, with lower educational levels and if they had older children," Overpeck said. "After the first week of life, infants are more likely to be killed by a male, but we only have information on the mothers."

Other risk factors include having received late or no prenatal care, and being Native American or African American.

Choking deaths common in smallest babies

Death due to choking on food was the sixth leading cause of injury death, accounting for 7 percent of all injury deaths.

"We were surprised to see a high rate of death due to choking on food, which was most prevalent in premature and low-birth-weight babies," Overpeck said. "It occurred primarily during the first 12 weeks of life and crossed all population groups."

Researchers hope the study's findings can be used to identify infants at risk and develop prevention strategies.

Injury deaths overall are the third leading cause of infant death. Sudden Infant Death Syndrome (SIDS) is first, followed by deaths due to birth defects.