How common are rib fractures in extremely low birth weight preterm infants?

BACKGROUND

This study was prompted by incidental finding of healing rib fractures on chest radiographs of ex-preterm born infants, who were admitted to hospital with acute respiratory illnesses within a few weeks of discharge from the neonatal intensive care unit (NICU). Rib fractures in infants, particularly those situated posteriorly, are considered to be specific for non-accidental injury (NAI).

METHODS

Retrospective examination of radiographs of extremely low birth weight (ELBW) infants (< or =1000 g) with a gestation range of 22 of 33 weeks, cared for at a tertiary NICU, between 1998 and 2002, and who had survived > or =4 weeks.

RESULTS

Five out of 72 (7%) infants studied had radiologically apparent rib fractures. None involved posterior rib shafts. All infants with rib fractures died on the NICU.

CONCLUSIONS

The possibility of NAI should be considered in ex-ELBW infants found to have rib fractures.