Year of Award

2014

Document Type

Dissertation

Degree Type

Doctor of Philosophy (PhD)

Degree Name

Anthropology (Cultural Heritage and Applied Anthropology Option)

Department or School/College

Department of Anthropology

Committee Chair

Ashley McKeown

Commitee Members

Kimber H. McKay, Randall R. Skelton, Jon M. Graham, J. Bruce Beckwith, Steven A. Symes

Abstract

The purpose of this study was to examine infant rib heads microscopically, document clefts in the anterior portion of the metaphysis and other findings including metaphyseal lesions, and statistically analyze these clefts and various features about the child, including circumstances of death (e.g., SIDS, bed sharing, or suspicious for abuse), whether or not CPR was performed, birth method, age in months at death, estimated gestational age at birth, and various socioeconomic factors (e.g., married or unmarried mother, biological father or boyfriend involved with care of child). The glass slides with microscopic sections of rib head, neck and variable amounts of adjacent shaft previously obtained at autopsy from 90 children were used. The clefts identified by the author in two sentinel cases were found in a majority of the other 88 children, and were consistent morphologically with a fracture, indicating that children’s ribs are easier to break than previously thought. The number of clefts per child was strongly associated with age in months at death. The number of clefts greater than 1.00 mm in length per child was unequally distributed amongst groups differentiating the circumstances of death, and found in greater number in the group representing suspicious deaths, implying that this microscopic finding may indicate abuse. No statistical association between the clefts and birth method or use of cardiopulmonary resuscitation during the terminal event was identified; however, single cases suggested otherwise. A statistical association between estimated gestational age and number of clefts per child was identified via correlation using Spearman’s method, but not other statistical analyses (i.e., Chi-square test and Poisson regression analysis). This study supports the microscopic examination of infant rib heads obtained at autopsy, as potentially significant findings (including metaphyseal lesions) that are not identified via radiologic or gross examination at autopsy would otherwise be missed; however, further investigation is required to better understand the implications of the histologic findings.

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© Copyright 2014 Walter Loren Kemp