Dataset Information

Breastfeeding and Exposure to Past, Current, and Neighborhood Violence.

ABSTRACT: Objectives Breastfeeding has short- and long-term health benefits for children and mothers, but US breastfeeding rates are suboptimal. Exposure to violence may contribute to these low rates, which vary by race/ethnicity. We studied: (1) whether patterns of violence exposure differ by race/ethnicity and (2) whether these patterns are associated with breastfeeding outcomes. Methods We conducted a secondary analysis of data drawn from self-report surveys completed by a convenience sample of low-income postpartum women (n?=?760) in upstate New York. Latent class analysis was used to identify groups of women with similar responses to seven violence measures, including childhood physical and/or sexual violence, experience of partner violence during or just after pregnancy (physical, emotional, verbal), and neighborhood violence (perceived or by ZIP code). Logistic regression and survival analysis were utilized to determine if classes were associated with breastfeeding initiation, duration, and exclusivity, controlling for demographics. Results Exposure to at least one form of violence was high in this sample (87%). We identified 4 classes defined by violence exposure (combining current and historical exposures). Violence exposure patterns differed between racial/ethnic groups, but patterns were inconsistently associated with breastfeeding plans or outcomes. For White women, history of violence exposure increased the likelihood of earlier breastfeeding cessation. By contrast, among Black women, history of violence exposure increased the likelihood of having a breastfeeding plan and initiating breastfeeding. Conclusions for Practice Some differences between violence exposure classes are likely due to the correlation between race/ethnicity and socioeconomic status in the community studied. Additional studies are warranted to better understand how exposure to violence is related to breastfeeding and how best to support women making decisions about intention, initiation, and duration of breastfeeding.

SUBMITTER: Holland ML

PROVIDER: S-EPMC5764770 | biostudies-other | 2018 Jan

REPOSITORIES: biostudies-other

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Breastfeeding and Exposure to Past, Current, and Neighborhood Violence.

Holland Margaret L ML Thevenent-Morrison Kelly K Mittal Mona M Nelson Alice A Dozier Ann M AM

Maternal and child health journal 20180101 1

Objectives Breastfeeding has short- and long-term health benefits for children and mothers, but US breastfeeding rates are suboptimal. Exposure to violence may contribute to these low rates, which vary by race/ethnicity. We studied: (1) whether patterns of violence exposure differ by race/ethnicity and (2) whether these patterns are associated with breastfeeding outcomes. Methods We conducted a secondary analysis of data drawn from self-report surveys completed by a convenience sample of low-inc ...[more]

PMID: 28766093

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Project description:ImportanceMuch is unknown about how individual and neighborhood factors converge in the association with risk for violent reinjury and violence perpetration.ObjectivesTo investigate the association of exposure to neighborhood racialized economic segregation with reinjury and use of violence against others among survivors of violent penetrating injury.Design, setting, and participantsThis retrospective cohort study was performed using data obtained from hospital, police, and state vital records. The study was performed at Boston Medical Center, an urban, level I trauma center that is the largest safety-net hospital and busiest trauma center in New England. The cohort included all patients treated for a nonfatal violent penetrating injury from 2013 to 2018. Patients with no Boston metropolitan area home address were excluded. Individuals were followed up through 2021. Data were analyzed from February to August 2022.ExposureAmerican Community Survey data were used to measure neighborhood deprivation using the racialized economic Index of Concentration at the Extremes (ICE) for patient residential address upon hospital discharge. ICE was measured on a scale from -1 (most deprived) to 1 (most privileged).Main outcomes and measuresPrimary outcomes were violent reinjury and police-reported perpetration of violence within 3 years of an index injury.ResultsOf 1843 survivors of violence (median [IQR] age, 27 [22-37] years; 1557 men [84.5%]; 351 Hispanic [19.5%], 1271 non-Hispanic Black [70.5%], and 149 non-Hispanic White [8.3%] among 1804 patients with race and ethnicity data), the cohort was skewed toward residing in neighborhoods with higher racialized economic segregation (median [IQR] ICE = -0.15 [-0.22 to 0.07]) compared with the state overall (ICE = 0.27). There were police encounters for violence perpetration among 161 individuals (8.7%) and violent reinjuries among 214 individuals (11.6%) within 3 years after surviving a violent penetrating injury. For each 0.1-unit increase in neighborhood deprivation, there was a 13% (hazard ratio [HR], 1.13; 95% CI, 1.03 to 1.25; P = .01) increase in risk of violence perpetration but no difference in risk for violent reinjury (HR, 1.03; 95% CI, 0.96 to 1.11; P = .38). The greatest occurrence for each outcome was within the first year after index injury; for example, incidents of violence perpetration occurred among 48 of 614 patients (7.8%) at year 1 vs 10 of 542 patients (1.8%) at year 3 in tertile 3 of neighborhood deprivation.Conclusions and relevanceThis study found that living in a more economically deprived and socially marginalized area was associated with increased risk of using violence against others. The finding suggests that interventions may need to include investments in neighborhoods with the highest levels of violence to help reduce downstream transmission of violence.

Project description:ObjectiveThe association between intimate partner violence (IPV) and breastfeeding is unclear. We conducted a systematic review to summarise the evidence of breastfeeding outcomes following exposure to IPV.DesignSystematic review.MethodsWe searched for published studies without study design or language restrictions (up to July 2019) in the following databases: PubMed, Embase, SCOPUS and The Global Health Library. Studies assessing various breastfeeding outcomes (initiation, duration and exclusive breastfeeding) in women exposed to IPV in any form (physical, psychological or sexual) and at any stage (1 year pre-pregnancy, during or post-pregnancy) were included. Two authors independently selected the studies and conducted the quality appraisal by use of the Newcastle-Ottawa Scale. Results were summarised taking precision and quality into account.ResultsA total of 16 studies (participants n=414 393) were included and they adjusted for a total of 48 different confounders. The majority of studies were cross-sectional (n=11) and most studies were judged to be fair/low quality. Four out of seven studies found that IPV exposure shortened breastfeeding duration (adjusted ORs/aORs=0.22 (95% CI: 0.05-0.85), 1.18 (95% CI: 1.01-1.37), 5.92 (95% CI: 1.72-27.98), 1.28 (95% CI: 1.18-1.39)). Further, 5/10 studies found that IPV led to early termination of exclusive breastfeeding (aORs=1.53 (95% CI: 1.01-23.1), 0.83 (95% CI: 0.71-0.96), 1.35 (95% CI: 1.07-1.71), 0.17 (95% CI: 0.07-0.4), 1839 (95% CI: 1.61-2911)) and 2/6 studies found that IPV significantly reduced breastfeeding initiation (aORs=2.00 (95% CI: 1.2-3.3), 0.81 (95% CI: 0.7-0.93)).ConclusionIPV exposure appears to associate negatively with some breastfeeding outcomes. Individual patient data meta-analysis is required to quantify the magnitude of the association for specific IPV-outcome combinations. More high-quality studies and definition of core confounders are warranted.Prospero registration numberCRD42019129353.

Dataset Information

Breastfeeding and Exposure to Past, Current, and Neighborhood Violence.

Publications

Breastfeeding and Exposure to Past, Current, and Neighborhood Violence.

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