A short and sickly life. Multi-indicator analysis of an infant from a late antique Italian burial site (Piano della Civita, Artena, 3rd-5th cent CE)

Objective: To evaluate pathological lesions and related growth impairment in an infant from a late antiquity context in central Italy. Materials: The individual labeled as 04.AR.60004 comes from a small burial plot in Piano della Civita di Artena, Italy, dated to the 3rd-5th centuries. Methods: Macroscopic examination, metric analysis, dental histomorphometry, amelogenin sequencing, and aDNA analyses were employed. Results: Individual 04.AR.60004 is an infant male with an estimated age-at-death of 2 months showing two metabolic stress events, one occurring before birth and one a few days before death. The well-preserved skeleton shows diffuse abnormal cortical porosity and subperiosteal new bone formation. Conclusions: The type and distribution of the skeletal lesions suggest a diagnosis of infantile scurvy, probably associated with a general status of malnutrition. Dimensions of cranial and postcranial bones show a wide discrepancy between the skeletal age (38-40 fetal weeks) and the dental histological age (2 months). Significance: Including enamel histology age-at-death estimation may expand our knowledge of the influence of severe pathological cases on growth. Limitations: Although scurvy remains the most obvious diagnosis, we cannot exclude other related micronutrient deficiencies which might have affected the individual. Suggestions for further research: Including dental histometric and molecular sex estimation in infant pathological cases can help us to recognize impaired growth and enhance our understanding of sex-based susceptibility and potential biases in childcare within ancient communities.