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This case report aims to highlight the challenges of diagnosing MSBP, its impact on victims, and the ethical implications for healthcare professionals. A 37\u2010year\u2010old woman charged with filicide of two of her offspring and deliberate intoxication of her remaining 3\u2010year\u2010old boy was diagnosed with MSBP. Despite the tragic outcome for two siblings, the timely intervention saved the life of the third child. This case adds to the existing literature related to MSBP. It illustrates the difficulties posed by and the perpetrator's ability to deceive healthcare providers. It emphasizes the need for a sound understanding of victims\u2019 and perpetrators' features to facilitate early evocation of the condition and thus prompt the adoption of adequate measures. To conclude, MSBP is a complex issue with significant diagnostic and ethical challenges. Early suspicion, careful evaluation, and a multidisciplinary approach are crucial for the protection of children and the appropriate management of perpetrators.<\/jats:p>","DOI":"10.1111\/1556-4029.70296","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T04:06:50Z","timestamp":1773029210000},"page":"1529-1534","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Serial maternal filicide as evidence of Munchausen syndrome by proxy"],"prefix":"10.1111","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5800-1001","authenticated-orcid":false,"given":"Ahlem","family":"Mtiraoui","sequence":"first","affiliation":[{"name":"Faculty of Medicine of Sousse Department of Psychiatry, Research Laboratory LR12ES04, Farhat Hached Hospital University of Sousse  Sousse Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oussama","family":"Ajmi","sequence":"additional","affiliation":[{"name":"Faculty of Medicine of Sousse Department of Psychiatry, Research Laboratory LR12ES04, Farhat Hached Hospital University of Sousse  Sousse Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Asma","family":"Allaya","sequence":"additional","affiliation":[{"name":"Faculty of Medicine of Sousse Department of Psychiatry, Research Laboratory LR12ES04, Farhat Hached Hospital University of Sousse  Sousse Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amel","family":"Braham","sequence":"additional","affiliation":[{"name":"Faculty of Medicine of Sousse Department of Psychiatry, Research Laboratory LR12ES04, Farhat Hached Hospital University of Sousse  Sousse Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaafar","family":"Nakhli","sequence":"additional","affiliation":[{"name":"Faculty of Medicine of Sousse Department of Psychiatry, Research Laboratory LR12ES04, Farhat Hached Hospital University of Sousse  Sousse Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,3,8]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/0022018318806426"},{"key":"e_1_2_9_3_1","volume-title":"UNICEF annual report 2008: United Nations Children's fund","author":"UNICEF","year":"2009"},{"issue":"3","key":"e_1_2_9_4_1","first-page":"345","article-title":"Maternal filicide in Quebec","volume":"30","author":"Bourget D","year":"2002","journal-title":"J Am Acad Psychiatry Law"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.erap.2019.03.002"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/cbm.695"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.avb.2015.01.011"},{"issue":"3","key":"e_1_2_9_8_1","first-page":"29","article-title":"Challenges in identifying and diagnosing postpartum disorders","volume":"11","author":"Born L","year":"2004","journal-title":"Prim Psychiatry"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600\u20100447.108.s418.11.x"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1092852920001741"},{"key":"e_1_2_9_11_1","first-page":"328","article-title":"Perinatal and postpartum depression: from attachment to personality. 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