Age-at-Death Estimation of Fetuses and Infants in Forensic Anthropology: A New "Coupling" Method to Detect Biases Due to Altered Growth Trajectories.

The coupling between maturation and growth in the age estimation of young individuals with altered growth processes was analyzed in this study, whereby the age was determined using a geometric morphometrics method. A medical sample comprising 223 fetuses and infants was used to establish the method. The shapes, quantified by elliptic Fourier analysis, were grouped into consensus stages to characterize the maturation process along increasing age groups. Each maturation stage was "coupled" to biometry by defining an associated femur length range. The method was tested on a validation sample of 42 normal individuals and a pathological sample of 114 individuals whose pathologies were medically assessed. Couplings were present in 90.48% of the normal sample and 77.19% of the pathological sample. The method was able to detect "uncoupling" (i.e., possibly altered growth) in more than 22.8% of samples, even if there was no visible traces of pathology on bones in most cases. In conclusion, experts should be warned that living conditions may cause alterations in the development of young individuals in terms of uncoupling, and that the age-at-death estimation based on long bone biometry could be biased. In a forensic context, when age has been estimated in cases where uncoupling is present, experts should be careful to take potential inaccuracies into account when forming their conclusions.