Abstract
BackgroundGirls exposed to violence have a high risk of being victimized as adults and are more likely than non-abused women to have children who are treated violently. This intergenerational transmission may be especially serious when women suffer violence during pregnancy and early motherhood, as it impairs maternal wellbeing and infant health and development. This study examined the intergenerational effects of being exposed to childhood maltreatment (CM) and prenatal intimate partner violence (p-IPV) on perinatal mental distress and birth outcomes in central Vietnam.MethodsA birth cohort study in Hue City, Vietnam was conducted with 150 women in the third trimester of pregnancy (Wave 1) and 3 months after childbirth (Wave 2). Using multivariable logistic regression models, augmented inverse-probability-weighted estimators and structural equation modelling (SEM), we analyzed a theoretical model by evaluating adjusted risk differences and pathways between CM, p-IPV and subsequent perinatal adversity and indicators of infant health problems.ResultsOne in two pregnant women experienced at least one form of CM (55.03%) and one in ten pregnant women experienced both CM and p-IPV (10.67%). Mothers who experienced p-IPV or witnessed IPV as a child were approximately twice as likely to experience poor mental health during pregnancy [ARR 1.94, 95% CI (1.20–3.15)]. Infants had a two-fold higher risk of adverse birth outcomes (low birth weight, preterm birth, admission to neonatal intensive care) [ARR 2.45 95% CI (1.42, 4.25)] if their mothers experienced any form of p-IPV, with greater risk if their mothers were exposed to both CM and p-IPV [ARR 3.45 95% CI (1.40, 8.53)]. Notably, significant pathways to p-IPV were found via adverse childhood experience (ACE) events (β = 0.13), neighborhood disorder (β = 0.14) and partner support (β = − 1.3).ConclusionThese results emphasize the detrimental and prolonged nature of the effect of violence during childhood and pregnancy. Exposure to childhood maltreatment and violence during pregnancy increases the risk of maternal mental health difficulties and adverse birth outcomes. Antenatal care systems need to be responsive to women’s previous experiences of violence and maternal mental health. The significant protective role of partner support and social support should also be considered when designing tailored interventions to address violence during pregnancy.
Highlights
Girls exposed to violence have a high risk of being victimized as adults and are more likely than nonabused women to have children who are treated violently
Around 28% of pregnant women experience physical or sexual Intimate-partner violence (IPV) during pregnancy [5] and a recent umbrella review of 12 studies found that emotional pIPV can be wide ranging, with between 1.8 to 67.4% [6]. prenatal intimate partner violence (p-IPV) is associated with a range of adverse perinatal outcomes, such as miscarriages and pre-term births [7]
18% reported moderate to high levels of symptoms of mental health problems
Summary
Girls exposed to violence have a high risk of being victimized as adults and are more likely than nonabused women to have children who are treated violently. This intergenerational transmission may be especially serious when women suffer violence during pregnancy and early motherhood, as it impairs maternal wellbeing and infant health and development. Children who were exposed to violence personally or who witnessed IPV as children become tomorrow’s perpetrators of violence against their children or spouses in adulthood [13] This term refers to the risk of being re-victimized in adulthood. Childhood experiences can create ongoing interpersonal and social vulnerabilities for revictimization via IPV in adulthood
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