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==Risk factors==
Common risk factors for Shakenshaken Babybaby Syndromesyndrome include perceived excessive crying, behavioral health problems, domestic violence history, frustration intolerance, lack of childcare experience, young infant age, young maternal age, multiple births, having a male infant, full-time working, postpartum depression, single parent families and economic adversity.<ref name="ReferenceA">{{Cite journal |date=2016-01-05 |title=Self-Reported Prevalence and Risk Factors for Shaking and Smothering Among Mothers of 4-Month-Old Infants in Japan |journal=Journal of Epidemiology |volume=26 |issue=1 |pages=4–13 |doi=10.2188/jea.JE20140216 |issn=0917-5040 |pmc=4690735 |pmid=26639749 | vauthors = Fujiwara T, Yamaoka Y, Morisaki N }}</ref><ref name=":11">{{Citation |last1=Joyce |first1=Tina |title=Pediatric Abusive Head Trauma |date=2024 |work=StatPearls |url=http://www.ncbi.nlm.nih.gov/books/NBK499836/ |access-date=2024-08-01 |place=Treasure Island (FL) |publisher=StatPearls Publishing |pmid=29763011 |last2=Gossman |first2=William |last3=Huecker |first3=Martin R.}}</ref> The perpetrators of acute head trauma typically involve the father, stepfather, mother's boyfriend, female babysitter and the mother.<ref name=":11" /> The age group from child birth to the age of 4 are at greater risk of SBS due to multiple factors, including disproportionate anatomy, lack of or inability to communicate needs, and inability to protect self from a larger adult.<ref name=cs>{{Cite journal |last=Walls |first=Carrie |date=September 2006 |title=Shaken Baby Syndrome Education: A Role for Nurse Practitioners Working With Families of Small Children |url=https://doi.org/10.1016/j.pedhc.2006.02.002 |journal=Journal of Pediatric Health Care |volume=20 |issue=5 |pages=304–310 |doi=10.1016/j.pedhc.2006.02.002 |pmid=16962435 |issn=0891-5245}}</ref>
Episodes of colic are greatest at 6 to 8 weeks of age, and studies have shown a peak in SBS incidence during this time as parents may perceive these episodes as excessive crying.<ref name="Joyce_Gossman_Huecker_2023" /> Caregivers that are at risk for becoming abusive often have unrealistic expectations of the child and may display "role reversal", expecting the child to fulfill the needs of the caregiver.<ref name="pmid11433079" /> [[Substance abuse]] and emotional stress, resulting for example from low [[socioeconomic status]] or family instability, are other risk factors for aggression and impulsiveness in caregivers.<ref name="pmid11433079" /><ref name=":6">{{cite journal | vauthors = Karibe H, Kameyama M, Hayashi T, Narisawa A, Tominaga T | title = Acute Subdural Hematoma in Infants with Abusive Head Trauma: A Literature Review | journal = Neurologia Medico-Chirurgica | volume = 56 | issue = 5 | pages = 264–273 | date = May 2016 | pmid = 26960448 | pmc = 4870181 | doi = 10.2176/nmc.ra.2015-0308 }}</ref> Caregivers of any gender can cause SBS, but cases of SBS have been reported to be more common amongst younger parents.<ref name="pmid11433079" /><ref name=":6" /> Studies have shown increased prevalence of SBS among parents 34 years old or younger, especially 24 years old or younger.<ref name="ReferenceA"/> Although it had been previously speculated that SBS was an isolated event, evidence of prior child abuse is a common finding.<ref name="pmid11433079" /> In an estimated 33–40% of cases, evidence of prior head injuries, such as old intracranial bleeds, is present.<ref name="pmid11433079" />
At the community level, risk factors for Shakenshaken Babybaby Syndromesyndrome include social isolation, lack of recreational facilities, lack of external support from family or governmental agencies, unsafe neighborhoods and societal factors such as poverty.<ref name=":11" /><ref name=cs/>
==Mechanism==
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