Dataset Information

Maternal emotional and physical intimate partner violence and early child development: investigating mediators in a cross-sectional study in a South African birth cohort

ABSTRACT:

Objectives

This study investigated associations between recent maternal intimate partner violence (IPV) (emotional, physical and sexual) and child development at 2 years as well as whether maternal depression or alcohol use mediated these relationships.

Design

Cross-sectional study nested in a South African birth cohort.

Setting

Two primary care clinics in Paarl, South Africa.

Participants

626 mother–child pairs; inclusion criteria for maternal antenatal enrolment were clinic attendance and remaining in the study area for at least 1 year; women were excluded if a minor.

Primary outcome measures

Child cognitive, language and motor development composite scores. These were assessed using the Bayley Scales of Infant and Toddler Development, third edition.

Results

Emotional IPV was associated with lower cognitive (β=−0.32; 95% CI −0.60 to –0.04), language (β=−0.36; 95% CI −0.69 to –0.01) or motor composite scores (β=−0.58; 95% CI −0.95 to –0.20) in children at 2 years of age. Physical IPV was associated with lower motor scores (β=−0.42; 95% CI −0.75 to –0.09) at 2 years. Sexual IPV was unrelated to developmental outcomes, possibly due to low prevalence. Neither recent maternal depression nor alcohol use were shown to mediate the relationship between IPV and developmental outcomes.

Conclusions

Interventions to reduce maternal physical and emotional IPV and early-life interventions for infants and toddlers are needed to promote optimal child development.

SUBMITTER: Barnett W

PROVIDER: S-EPMC8557296 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundA strong evidence base indicates that maternal caregivers' experience of intimate partner violence [IPV] impacts children's health, cognitive development, and risk-taking behaviors. Our objective was to review peer-reviewed literature describing the associations between a child's indirect exposure to IPV and corresponding nutrition outcomes, with a particular focus on fragile settings in low and middle-income countries [LMICs].MethodsWe conducted a rapid evidence assessment to synthesize quantitative associations between maternal caregivers' IPV experience and children's nutrition/growth outcomes (birthweight, feeding, and growth indicators). We included peer-reviewed research, published in English or Spanish after the year 2000, conducted in fragile settings in LMICs.ResultsWe identified 86 publications that fit inclusion criteria. Amongst all associations assessed, a maternal caregiver's experience of combined forms of IPV (physical, sexual and emotional) or physical IPV only, were most consistently associated with lower birthweight, especially during pregnancy. Women of child-bearing age, including adolescents, exposed to at least one type of IPV showed a decreased likelihood of following recommended breastfeeding practices. Lifetime maternal experience of combined IPV was significantly associated with stunting among children under 5 years of age in the largest study included, though findings in smaller studies were inconsistent. Maternal experience of physical or combined IPV were inconsistently associated with underweight or wasting in the first five years. Maternal experience of sexual IPV during pregnancy appeared to predict worsened lipid profiles among children.ConclusionMaternal caregivers' experience of IPV is significantly associated with low birthweight and suboptimal breastfeeding practices, whereas studies showed inconsistent associations with child growth indicators or blood nutrient levels. Future research should focus on outcomes in children aged 2 years and older, investigation of feeding practices beyond breastfeeding, and examination of risk during time periods physiologically relevant to the outcomes. Programmatic implications include incorporation of GBV considerations into nutrition policies and programming and integrating GBV prevention and response into mother and child health and nutrition interventions in LMIC contexts.

Project description:Introduction and backgroundIntimate partner violence (IPV) and child malnutrition are global public health issues. Assessing the association between IPV and child anthropometric failures (stunting, underweight, and wasting) in 29 Sub-Saharan African (SSA) countries can provide significant global health solutions. Some studies have found an association between IPV against women and child malnutrition, but the conclusions are inconsistent. The physical and psychological conditions, living environment, and rights of the mother may be involved.MethodsWe collected and analyzed the Demographic and Health Surveys data (2010-2021) of 29 SSA countries. The main exposure variables were various types of IPV, classified as physical, sexual, and emotional violence. The outcome was the child's development index, which can be roughly divided into stunting, wasting, and underweight. An adjusted binary logistic regression model was used to test the relationship between IPV and children's nutritional status.ResultsA total of 186,138 children under 5 years of age were included in the analysis; 50,113 (27.1%) of the children were stunted, 11,329 (6.1%) were wasted, and 39,459 (21.3%) were underweight in all regions. The child's gender, age, duration of breastfeeding, complementary feeding, and vitamin A supplements intake in the past 6 months were associated with their nutritional status (p < 0.001). Sexual violence was the strongest factor associated with stunting, which remained statistically significant after controlling all variables (AOR = 1.11; 95% CI: 1.02, 1.21; p = 0.012). We also found a small negative association between wasting and IPV. For underweight, there were no associations with IPV after controlling for all variables (p > 0.05).ConclusionIPV is positively associated with child stunting in SSA countries. Sexual violence showed a strong positive correlation with stunting. Wasting was unexpectedly negatively associated with IPV. There was no clear correlation between underweight and violence.