The medico-legal investigation of abandoned fetuses and newborns—a review of cases admitted to the Pretoria Medico-Legal Laboratory, South Africa

Toit-Prinsloo, Lorraine Du; Pickles, Camilla; Smith, Zoe; Jordaan, Joyce; Saayman, Gert

doi:10.1007/s00414-015-1198-y

Cited by 14 publications

(9 citation statements)

References 14 publications

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“…[13,14] And female infants are more often killed in countries such as China, Taiwan, South Korea, and Pakistan. [15] Consistent with this, in our study, there were 3 female babies killed and 1 male.…”

Section: Discussionsupporting

confidence: 89%

Fetal, neonatal, and infant death in central China (Hubei)

Deng

Wang

Zhou³

et al. 2019

Medicine

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Data based on forensic autopsy in neonates and infants in China are rare in the literature. The purpose of this study is to evaluate the characteristics of fetal, neonatal, and infant death and to determine the main cause of death among them. A retrospective analysis of fetal and infant forensic autopsies referred to the Tongji Forensic Medical Center (TFMC) in Hubei, central China, during a 16-year period between January 1999 and December 2014, was performed. In this period, there were 1111 males and 543 females; the total male-to-female ratio (MFR) was 2.05:1. There were 173 fetal and infant autopsies conducted, comprised of 43 fetal, 84 neonatal (<28 days) and 46 infant (4 weeks to 1 year) cases. The annual case number ranged from 5 in 2004 to 18 in 2014 (annual mean of 10.8). MFR was 1.75:1. About 94% of these deaths (163/173) resulted from natural causes, 6 cases (3.5%) were accidental deaths, and 4 (2.3%) resulted from homicide (4 abandoned babies). Among fetuses, the most common causes of death were placental and umbilical cord pathologies (28%, 12/43), followed by intrapartum asphyxia resulting from amniotic fluid aspiration (AFA) or meconium aspiration syndrome (MAS) (18.6%, 8/43), congenital malformation (14%, 6/43), and intrapartum infection (9.3%, 4/43). A majority of neonatal deaths (66.7%, 56/84) died within 24 hours of birth. The main causes of neonatal death were asphyxia resulting from AFA, MAS, or hyaline membrane disease, and congenital malformation. The main causes of infant (1–12 months) death were infectious diseases, including pneumonia, meningitis, and viral brainstem encephalitis. This study was the 1st retrospective analysis of autopsies of fetal, neonatal, and infant death in TFMC and central China. We delineate the common causes of early demise among cases referred for autopsy, and report a male preponderance in this population. Our data observed that placental and/or umbilical cord pathology, asphyxia due to AFA, and/or MAS, and pneumonia were the leading causes of fetal, neonatal, and infant death, respectively. And it can inform clinical practitioners about the underlying causes of some of the most distressing cases in their practices.

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Section: Discussionsupporting

confidence: 89%

Fetal, neonatal, and infant death in central China (Hubei)

Deng

Wang

Zhou³

et al. 2019

Medicine

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“…2) and internationally are thought to be under-reported owing to the manner in which the fetuses and neonates are 'disposed'; [24] therefore, these statistics are suspected to be unreliable. [25][26][27][28] In these cases, identification is exceptionally challenging owing to the overall lack of secondary identifiers, as well as the absence of stored fingerprints and reference DNA profiles on databases (due to the young age of the decedents). While DNA can be useful for identification if a family member comes forward, it is suspected in at least some of these cases that the mother intentionally abandoned the neonate and is unlikely to come forward.…”

Section: Researchmentioning

confidence: 99%

Bodies without names: A retrospective review of unidentified decedents at Salt River Mortuary, Cape Town, South Africa, 2010 - 2017

2020

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Background. Decedents who remain unidentified and/or unclaimed following postmortem investigations are an international occurrence. Salt River Mortuary (SRM), one of the largest and busiest mortuaries in Cape Town, South Africa, also experiences this burden; however, little is known about the nature of these cases. Objectives. To review all cases admitted to SRM between 1 January 2010 and 31 December 2017 (n=26 960), with the objectives of quantifying the number of decedents who remained unidentified, and to better understand circumstances surrounding death and the identification methods that were attempted. Methods. Data pertaining to unidentified cases were collected from mortuary burial records and medicolegal case files. Data were analysed using Microsoft Excel 2013 (Microsoft, USA). Results. Over the 8-year period, 2 476 cases (mean 9.2% of caseload per annum) admitted to SRM remained unidentified. Bodies underwent an autopsy after a median of 3 days after a death declaration. However, in cases of decomposition, skeletonisation or other physical inhibitors of visual identification (n=345; 14.1%), the time between death and autopsy was undetermined owing to the overall lack of entomology analyses. Approximately 56.9% (n=1 408) of cases were between 20 and 50 years of age, and were predominantly males (78.7%). Unnatural injury-related deaths accounted for 32.4% of unidentified deaths, with firearms, assault and stabbings contributing approximately one-third each. With regard to identification attempts, forensic anthropology was requested in only 1.5% of these cases, and DNA analysis appeared to be used in only 23.6% of cases. Data pertaining to secondary identifiers, forensic odontology and fingerprint analyses were not formally recorded. Conclusions. The relatively short time interval between death declaration and postmortem examination suggests that DNA analysis should be more regularly utilised. Furthermore, it is urged that other ancillary investigations should be more regularly employed; that there is a greater collaboration between stakeholders and identification attempts; and that results are centrally recorded.

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“…Rates of abandonment are rarely available (Lee, Li, Kwong, & So, 2006;Sherr et al, 2009). Annual rates range from 3000 babies per annum in Italy (Ferrara et al, 2013) to 16 babies per annum in the United Kingdom (Sherr et al, 2009), with poverty (du Toit-Prinsloo, Pickles, Smith, Jordaan, & Saayman, 2016;Jacobs, Hornsby, & Marais, 2014) and governmental policy i.e. the one child policy in China (Li, Wu, Ge, & Ma, 2012), being identified as potential drivers of such phenomenon.…”

Section: Introductionmentioning

confidence: 99%

Disclosure and identity experiences of adults abandoned as babies: A qualitative study

2018

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There is intense debate regarding the disclosure experience of those children born from new technologies, surrogacy or adoption, yet no single study of those adopted after being abandoned as infants. This qualitative study examined disclosure for adult survivors of abandonment. Sixteen interviews were recorded and coded. A deductive approach to thematic analysis was used to create higher order themes and sub-themes. Findings are centred around the experience of disclosure, the process of disclosure specifically exploring the role of half-truths and finally the impact of disclosure on the search for identity and self. Disclosure was often delayed with traumatic effect. Adoption disclosure was separated from abandonment disclosure. Abandonment facts were often discovered at life event moments-weddings, death of an adoptive parent or the birth of a baby. Abandoned babies, as adults, often resorted to press/media to track their original circumstances, to seek out relatives and finders. Such searches were emotion filled, at high personal cost and often with dead-end consequences. Naming (e.g. after a railway station or shop name) was often linked to place or person surrounding the abandonment circumstances and this amplified the pain when discovered. Most ABOUT THE AUTHORSProfessor Lorraine Sherr is a professor of Clinical and Health Psychology at University College London. She has played a key role in research, policy and provision in the area of fragile families.Kathryn Roberts is a researcher based within the Institute for Global Health at Univeristy College London with an interest in the psychology of families, mental health and gloabl health.Natasha Croome is a doctoral student specialising in mental health.

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The medico-legal investigation of abandoned fetuses and newborns—a review of cases admitted to the Pretoria Medico-Legal Laboratory, South Africa

Cited by 14 publications

References 14 publications

Fetal, neonatal, and infant death in central China (Hubei)

Fetal, neonatal, and infant death in central China (Hubei)

Bodies without names: A retrospective review of unidentified decedents at Salt River Mortuary, Cape Town, South Africa, 2010 - 2017

Disclosure and identity experiences of adults abandoned as babies: A qualitative study

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