Childhood adversity predicts Intimate Partner Violence among American Indian women

Abstract

PurposeAmerican Indian (AI) populations experience high rates of Adverse Childhood Experiences (ACEs) compared to other racial/ethnic groups. Intimate Partner Violence (IPV) is a contributing factor in the Missing Murdered Indigenous People crisis. To provide data regarding ACEs and IPV surrounding pregnancy among AI populations, we tested the hypothesis that AI women with high ACEs would have higher risk of IPV and explored potential effect modification by income. MethodsData for 2341 (weighted) AI women were drawn from 2017 to 2020 North Dakota Pregnancy Risk Assessment Monitoring System (PRAMS) Survey. Participants reported yes/no to 10 ACEs questions regarding traumatic experiences before age 18 (high ACEs≥2). IPV was self-reported before or during pregnancy (perpetrator: husband/partner, ex-husband/ex-partner, or any). Annual income was dichotomized(high: >$16,000) on sample median. Logistic regression models estimated odds ratios (OR) and 95% confidence intervals (95% CI) for the association between ACEs and IPV before and during pregnancy, overall, and by income. Analyses were adjusted for sociodemographic factors. ResultsCompared to those with low ACEs, women with high ACEs were more likely to experience any IPV before (OR: 3.24, 95% CI: 1.78, 5.88) and during (OR: 2.34, 95% CI: 1.27, 4.31) pregnancy. Experience of sexual, verbal, physical violence, and exposure to intergenerational violence were associated with at least two-fold higher odds of any IPV before and during pregnancy. Effect modification by income was inconsistent. ConclusionsHigh ACEs were associated with IPV surrounding pregnancy among AI women. Sexual, verbal, physical, and intergenerational violence ACEs may particularly increase risk of IPV. Given the Missing Murdered Indigenous People crisis and perinatal disparities facing AI populations, these data are important to address ACEs and IPV among AI populations.