Abusive head trauma in children under 2 years of age in Latin America: a systematic review

Among the types of violence against children, abusive head trauma (AHT) is recognized as one of the main causes of violent death and neurological disabilities in infants. The scope of this systematic review was to examine the scenario and knowledge about AHT in Latin American countries based on studies conducted in Latin America and/or published by Latin American researchers between 2010 and 2024 (15 years). This systematic review was conducted in the PubMed/NIH (National Library of Medicine; National Center for Biotechnology Information), SciELO (Scientific Electronic Library Online), and LILACS (Latin American and Caribbean Literature in Health Sciences) databases. This systematic review was recorded in the Prospective International Registry of Systematic Reviews (PROSPERO CRD42025628791). Among the 462 articles found in the databases, 23 studies were published by Latin American researchers. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, only 7 articles met the eligibility criteria. Among children with traumatic brain injury, the presence of seizures (70% vs. 46%; p < 0.0001), retinal hemorrhages (78% vs. 3%; p < 0.0001), and subdural hematoma (91% vs. 29%; p < 0.0001) prevailed in suspected or confirmed cases of AHT. There is a shortage of scientific articles on AHT with sufficient sample size to allow us to know the geographic distribution of this event in Latin America. However, Latin American researchers recognize an unwitnessed or incoherent history of trauma along with a lowered level of consciousness, seizures, retinal hemorrhages, and subdural hematoma as strong indicators for suspicion of AHT.