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

Journal: Diagnostics (Basel, Switzerland)
Published Date: May 30, 2025

Abstract

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. 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. 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. : 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.

Authors

  • Kallirroi Fragkou
    Department of Forensic Medicine and Toxicology, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece.
  • Ioannis Ketsekioulafis
    Department of Forensic Medicine and Toxicology, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece.
  • Athina Tousia
    Department of Forensic Medicine and Toxicology, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece.
  • Maria Piagkou
    Department of Anatomy, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece.
  • Flora Bacopoulou
    Center 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, Greece.
  • Panagiotis Ferentinos
    Department of Psychiatry, Athens University Medical School, Athens, Greece.
  • Pierre-Antoine Peyron
    Department of Legal Medicine, CHU Reunion, University of Reunion, 97400 Saint-Denis, France.
  • Eric Baccino
    EDPFM, Department of Legal Medicine CHU Montpellier, University of Montpellier, 34000 Montpellier, France.
  • Laurent Martrille
    EDPFM, Department of Legal Medicine CHU Montpellier, University of Montpellier, 34000 Montpellier, France.
  • Stavroula Papadodima
    Department of Forensic Medicine and Toxicology, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece.

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