From Fragile Lives to Forensic Truth: Multimodal Forensic Approaches to Pediatric Homicide and Suspect Death

<b>Background:</b> Forensic investigation of child homicides presents unique challenges due to the vulnerability of children and the complexity of distinguishing between natural, accidental, and intentional manner of death. A multidisciplinary approach integrating traditional forensic me...

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Main Authors: Kallirroi Fragkou, Ioannis Ketsekioulafis, Athina Tousia, Maria Piagkou, Flora Bacopoulou, Panagiotis Ferentinos, Pierre-Antoine Peyron, Eric Baccino, Laurent Martrille, Stavroula Papadodima
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/15/11/1383
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author Kallirroi Fragkou
Ioannis Ketsekioulafis
Athina Tousia
Maria Piagkou
Flora Bacopoulou
Panagiotis Ferentinos
Pierre-Antoine Peyron
Eric Baccino
Laurent Martrille
Stavroula Papadodima
author_facet Kallirroi Fragkou
Ioannis Ketsekioulafis
Athina Tousia
Maria Piagkou
Flora Bacopoulou
Panagiotis Ferentinos
Pierre-Antoine Peyron
Eric Baccino
Laurent Martrille
Stavroula Papadodima
author_sort Kallirroi Fragkou
collection DOAJ
description <b>Background:</b> Forensic investigation of child homicides presents unique challenges due to the vulnerability of children and the complexity of distinguishing between natural, accidental, and intentional manner of death. A multidisciplinary approach integrating traditional forensic methods with emerging technologies is crucial to ensure accurate diagnosis and effective legal outcomes. <b>Methods:</b> This review examines current and emerging forensic techniques used in neonate, infant, and older child homicide investigations. It highlights advancements in postmortem imaging, histological examination, microbiological analysis, toxicology, and molecular autopsy. <b>Results:</b> Traditional forensic autopsy remains the cornerstone of child homicide investigations, providing critical insights into external and internal injuries. Histological examination enhances diagnostic accuracy by detecting microscopic evidence of trauma and infectious diseases. Postmortem imaging techniques are complementary for better identifying fractures, soft tissue injuries, and vascular abnormalities. Forensic toxicology plays a key role in detecting poisoning, while postmortem microbiology aids in identifying infectious causes of death. Furthermore, advancements in molecular autopsy and genetic testing have significantly enhanced the identification of hereditary conditions linked to sudden unexplained deaths in children, especially in cases involving multiple child fatalities within the same family, where forensic investigations are needed to accurately differentiate between natural causes and potential criminal involvement. <b>Conclusions</b>: A multidisciplinary approach incorporating traditional autopsy with postmortem imaging, histological examination, toxicology, postmortem microbiology, and molecular autopsy is essential for comprehensive forensic analysis, promoting both justice and prevention of fatal child abuse/homicide. Future research should focus on standardizing forensic protocols and exploring the potential of artificial intelligence (AI) in forensic investigations.
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spelling doaj-art-c8eaf3382dd749c190874e993b9743852025-08-20T03:11:30ZengMDPI AGDiagnostics2075-44182025-05-011511138310.3390/diagnostics15111383From Fragile Lives to Forensic Truth: Multimodal Forensic Approaches to Pediatric Homicide and Suspect DeathKallirroi Fragkou0Ioannis Ketsekioulafis1Athina Tousia2Maria Piagkou3Flora Bacopoulou4Panagiotis Ferentinos5Pierre-Antoine Peyron6Eric Baccino7Laurent Martrille8Stavroula Papadodima9Department of Forensic Medicine and Toxicology, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, GreeceDepartment of Forensic Medicine and Toxicology, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, GreeceDepartment of Forensic Medicine and Toxicology, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, GreeceDepartment of Anatomy, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, GreeceCenter for Adolescent Medicine and UNESCO Chair in Adolescence Health Care, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, 115 27 Athens, GreeceAffective Disorders and Suicide Unit, 2nd Department of Psychiatry, “Attikon” University General Hospital, School of Medicine, National and Kapodistrian University of Athens, 124 62 Athens, GreeceDepartment of Legal Medicine, CHU Reunion, University of Reunion, 97400 Saint-Denis, FranceEDPFM, Department of Legal Medicine CHU Montpellier, University of Montpellier, 34000 Montpellier, FranceEDPFM, Department of Legal Medicine CHU Montpellier, University of Montpellier, 34000 Montpellier, FranceDepartment of Forensic Medicine and Toxicology, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece<b>Background:</b> Forensic investigation of child homicides presents unique challenges due to the vulnerability of children and the complexity of distinguishing between natural, accidental, and intentional manner of death. A multidisciplinary approach integrating traditional forensic methods with emerging technologies is crucial to ensure accurate diagnosis and effective legal outcomes. <b>Methods:</b> This review examines current and emerging forensic techniques used in neonate, infant, and older child homicide investigations. It highlights advancements in postmortem imaging, histological examination, microbiological analysis, toxicology, and molecular autopsy. <b>Results:</b> Traditional forensic autopsy remains the cornerstone of child homicide investigations, providing critical insights into external and internal injuries. Histological examination enhances diagnostic accuracy by detecting microscopic evidence of trauma and infectious diseases. Postmortem imaging techniques are complementary for better identifying fractures, soft tissue injuries, and vascular abnormalities. Forensic toxicology plays a key role in detecting poisoning, while postmortem microbiology aids in identifying infectious causes of death. Furthermore, advancements in molecular autopsy and genetic testing have significantly enhanced the identification of hereditary conditions linked to sudden unexplained deaths in children, especially in cases involving multiple child fatalities within the same family, where forensic investigations are needed to accurately differentiate between natural causes and potential criminal involvement. <b>Conclusions</b>: A multidisciplinary approach incorporating traditional autopsy with postmortem imaging, histological examination, toxicology, postmortem microbiology, and molecular autopsy is essential for comprehensive forensic analysis, promoting both justice and prevention of fatal child abuse/homicide. Future research should focus on standardizing forensic protocols and exploring the potential of artificial intelligence (AI) in forensic investigations.https://www.mdpi.com/2075-4418/15/11/1383child homicidechild abuseinfanticidepostmortem imaginghistological examinationforensic toxicology
spellingShingle Kallirroi Fragkou
Ioannis Ketsekioulafis
Athina Tousia
Maria Piagkou
Flora Bacopoulou
Panagiotis Ferentinos
Pierre-Antoine Peyron
Eric Baccino
Laurent Martrille
Stavroula Papadodima
From Fragile Lives to Forensic Truth: Multimodal Forensic Approaches to Pediatric Homicide and Suspect Death
Diagnostics
child homicide
child abuse
infanticide
postmortem imaging
histological examination
forensic toxicology
title From Fragile Lives to Forensic Truth: Multimodal Forensic Approaches to Pediatric Homicide and Suspect Death
title_full From Fragile Lives to Forensic Truth: Multimodal Forensic Approaches to Pediatric Homicide and Suspect Death
title_fullStr From Fragile Lives to Forensic Truth: Multimodal Forensic Approaches to Pediatric Homicide and Suspect Death
title_full_unstemmed From Fragile Lives to Forensic Truth: Multimodal Forensic Approaches to Pediatric Homicide and Suspect Death
title_short From Fragile Lives to Forensic Truth: Multimodal Forensic Approaches to Pediatric Homicide and Suspect Death
title_sort from fragile lives to forensic truth multimodal forensic approaches to pediatric homicide and suspect death
topic child homicide
child abuse
infanticide
postmortem imaging
histological examination
forensic toxicology
url https://www.mdpi.com/2075-4418/15/11/1383
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