Prenatal Intimate Partner Violence Research Articles

Longitudinal Exploration of Prenatal and Postnatal Intimate Partner Violence, Postpartum Depression, and Child-Mother Attachment: A Mediation Model.

This longitudinal study examines the timelines of occurrences of intimate partner violence (IPV) on child-mother attachment, as well as the mediating role of maternal postpartum depression (PPD). Using a sample in the United States (N = 2,268), findings suggest that, compared to mothers' prenatal IPV victimization, postnatal IPV more negatively influences child-mother attachment when the children were at 3 years old, and this negative impact on attachment was partially mediated through maternal PPD. As IPV screening for pregnant women in healthcare settings becomes a common practice, effective IPV and PPD screening postnatally should be broadly implemented to promote maternal mental health and child-mother attachment.

Reliability of the revised conflict tactics scales (CTS2) in measuring prenatal intimate partner violence in the central region of Vietnam

Introduction: Prenatal intimate partner violence (p-IPV) is drawing much attention from society and researchers due to its significant increase and complexity. There is no standardized scale to collect information related to p-IPV in Vietnam. Thus, our study aims to evaluate the reliability of the scale used to measure p-IPV. Methods: A cross-sectional study was conducted on 495 pregnant women in their third trimester (gestational age from 28-42 weeks) in Da Nang city. Information on p-IPV was collected based on Revised Conflict Tactics Scales (CTS2). Based on Cronbach's alpha (α) and McDonald’s omega (ω), and test-retest to evaluate the reliability and validity of the scale. Results: Our study found that p-IPV was observed in 27.8% of pregnant women, with the proportion of those enduring all three types of violence being 3.4%; experiencing any two forms of violence was 12.9%, and facing one type of violence was 11.4%. The CTS2 scale is evaluated with Cronbach's alpha (α) and McDonald’s omega (ω), and a test-retest of ≥0.8. Conclusion: The CTS2 has high reliability and can be utilized to explore aspects of i-IPV in the Central region of Vietnam. Keywords: Revised Conflict Tactics Scales (CTS2), intimate partner violence (IPV), pregnant women.

Magnitude of self-reported intimate partner violence against pregnant women in Ghana’s northern region and its association with low birth weight

BackgroundLow birth weight (LBW) rates are high in the northern region of Ghana, as is tolerance for intimate partner violence (IPV). However, the relationship between the two incidents has not been established. This study assessed the magnitude of IPV against pregnant women and its association with LBW in the northern region of Ghana.MethodsA cross-sectional study was conducted among 402 postnatal women from five public health care facilities in the Tamale Metropolitan Area, northern Ghana. Data were collected electronically during face-to-face interviews. Validated methods were used to determine IPV exposure during pregnancy and birth weight. Multivariable logistic regression was used to identify the independent association between prenatal exposure to IPV and LBW.ResultsOf the 402 women, 46.5% (95% CI: 41.7, 51.4) experienced IPV during their most recent pregnancy. Of these, 34.8% were psychologically abused, 24.4% were sexually abused, and 6.7% were physically abused. Prenatal IPV exposure was found to be significantly associated with birth weight. Low birth weight was twice as likely among exposed women as among unexposed women (AOR = 2.42; 95% CI: 1.12, 5.26, p < 0.05). Low birth weight risk was also higher among women with anaemia in the first trimester (AOR = 3.47; 95% CI: 1.47, 8.23, p < 0.01), but was lower among women who made at least four antenatal care visits before delivery (AOR = 0.35; 95% CI: 0.14, 0.89, p < 0.05) and male newborns (AOR = 0.23; 95% CI: 0.11, 0.49, p < 0.001).Conclusion and recommendationIPV during pregnancy is prevalent in the research population, with psychological IPV being more widespread than other kinds. Women who suffered IPV during pregnancy were more likely to have LBW than those who did not. It is essential to incorporate questions about domestic violence into antenatal care protocols. In particular, every pregnant woman should be screened for IPV at least once during each trimester, and those who have experienced violence should be closely monitored for weight gain and foetal growth in the study setting to avert the LBW associated with IPV.Plain English summaryIn the northern region of Ghana, the number of babies born with low birth weight is high, as is the number of adults who are willing to put up with intimate partner violence. However, there has not been any proof that these two incidents are connected. This study looked at how frequently intimate partner violence occurs among pregnant women and how it is linked to low birth weight in northern Ghana’s Tamale Metropolitan Area. A cross-sectional study was conducted with 402 postnatal women from five public health care facilities in the study setting. Information on exposure to intimate partner violence during pregnancy and the birth weight of babies was collected electronically during face-to-face interviews. The study found that of the 402 women, 46.5% had experienced violence by an intimate partner during their most recent pregnancy. Out of these, 34.8% were abused psychologically, 24.4% were abused sexually, and 6.7% were abused physically. Women who were abused were more likely than those who were not to have babies with low birth weight. We concluded that intimate partner violence is common during pregnancy in the study setting and that more women suffered psychological intimate partner violence than other types of violence. Intimate partner violence during pregnancy was linked to low birth weight in the study setting. It is important for antenatal care plans to include questions about intimate partner violence. In particular, every pregnant woman should be assessed for intimate partner violence at least once during each trimester for monitoring.

Developmental Consequences of Intimate Partner Violence on Children.

Numerous studies associate childhood exposure to intimate partner violence (IPV) with adverse adjustment in the domains of mental health, social, and academic functioning. This review synthesizes this literature and highlights the critical role of child self-regulation in mediating children's adjustment outcomes. We discuss major methodological problems of the field, including failure to consider the effects of prenatal IPV exposure and the limitations of variable-oriented and cross-sectional approaches. Finally, we present a comprehensive theoretical model of the effects of IPV on children's development. This model includes three mechanistic pathways-one that is unique to IPV (maternal representations) and two that are consistent with the effects of other stressors (maternal mental health and physiological functioning). In our model, the effects of these three pathways on child adjustment outcomes are mediated through parenting and child self-regulation. Future research directions and clinical implications are discussed in the context of the model. Expected final online publication date for the Annual Review of Clinical Psychology, Volume 19 is May 2023. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Intimate partner violence and barriers to prenatal care

RationalePast research has shown that intimate partner violence (IPV) is associated with less adequate access to prenatal care. However, less is known about why IPV creates challenges for accessing prenatal care, including how IPV is related to unique barriers to prenatal care. ObjectiveThe aim of this study is to examine the association between physical IPV around the time of pregnancy (preconception IPV, prenatal IPV, or both preconception and prenatal IPV) and (1) adequacy of prenatal care, and (2) barriers to prenatal care. MethodsData are from 35 sites (34 states and New York City) from the Pregnancy Risk Assessment Monitoring System (PRAMS) for years 2009–2016 (n = 166,840). Adequacy of prenatal care is examined using multinomial logistic regression and measures of barriers to prenatal care are assessed using negative binomial regression and logistic regression. ResultsThe findings reveal that women with IPV exposure—especially those who experience IPV both before and during pregnancy—are more likely to experience inadequate prenatal care. In addition, women with IPV exposure incur a higher rate of barriers to prenatal care, as well as several specific barriers to prenatal care including not having transportation, not being able to get time off work, being too busy, being unable to find child care, and keeping a pregnancy a secret. ConclusionsConsidering the adverse consequences of both IPV and inadequate access to prenatal care for maternal and child health, the findings of this study highlight the need for public health interventions that both reduce the prevalence of IPV and remove barriers to prenatal care for IPV-exposed women.

Prenatal Exposure to Intimate Partner Violence and Developmental Health in Children at Kindergarten: Linking Canadian Population-Level Administrative Data.

ObjectiveUsing population-wide administrative data, the objective was to provide Canadian evidence on the longitudinal relationship between maternal intimate partner violence (IPV) victimization and children’s developmental health. Using provincial prosecution records, we examined developmental vulnerability (DV) at kindergarten of children prenatally exposed to maternal IPV victimization compared to unexposed counterparts.&#x0D; ApproachThis retrospective cohort study linked administrative datasets (legal, health, education, social services) from the Population Research Data Repository at the Manitoba Centre for Health Policy. Exposed mother-child pairs with 1+ prosecution record of maternal IPV victimization during pregnancy between 2003 and 2018 in Manitoba (n = 1,117) were matched to unexposed pairs (1:3) based on sex/birthdate of child and neighbourhood income. DV at kindergarten was measured across 5 domains (physical, social, emotional, language/cognitive [LC], communication/general knowledge) using the Early Developmental Instrument (EDI). Children without eligible EDI scores were excluded. Multiple logistic regression models were conducted to address the objective.&#x0D; ResultsThe eligible cohort included 927 children (exposed n=229, unexposed n=698); 31.07% of the cohort was developmentally vulnerable in one or more domains (1/+) and 19.53% was developmentally vulnerable in two or more domains (2/+). Children who were prenatally exposed to maternal IPV victimization had increased odds of vulnerability across all 5 developmental domains (e.g., physical health/wellness: OR=2.83[1.95,4.10]; LC development: OR=2.45[1.65,3.64]). Unadjusted ORs showed statistically significant associations between maternal exposure of prenatal IPV victimization and DV in 1/+ (OR=2.70[1.98,3.68]) and 2/+ (OR=2.48[1.75,3.50]). When adjusted for covariates (e.g., maternal income assistance, mental health, child abuse history), no statistically significant relationship was found for any of the domains (e.g., LC development: aOR=0.98[0.53,1.81]), 1/+ (aOR=1.17[0.72,1.88]), and 2/+ (aOR=1.14[0.67,1.95]).&#x0D; ConclusionThe unadjusted, statistically significant associations suggest children exposed to maternal IPV victimization prenatally may face associated social/health risks. The finding highlights the need to consider potential factors that put children at risk of DV when developing and implementing support systems/interventions for children exposed to maternal IPV victimization.

The influence of childhood abuse and prenatal intimate partner violence on childbirth experiences and breastfeeding outcomes

BackgroundDespite the detrimental effects and life-course health consequences of violence exposure, relatively few studies have adequate capacity to investigate the evolution of violence from childhood to motherhood. ObjectiveThis study aims to examine the cyclical nature of childhood abuse and prenatal inter-partner violent victimization (p-IPV) and its adverse impact on childbirth trauma and exclusive breastfeeding (EBF) practice in Vietnam. MethodUsing a prospective birth cohort, 150 pregnant women were recruited in the third trimester of pregnancy in Hue city in central Vietnam (Wave 1-Baseline) and re-interviewed approximately three months after delivery (Wave 2-Follow-up). The direct and indirect effects of violent victimization on subsequent childbirth experience (measured by Birth Memories and Recall Questionnaire) and EBF practice were estimated by using augmented-inverse-probability-weighted models, sensitivity analysis, and structural equation model. ResultsDetrimental and prolonged effects of the inter-generational cycle of violence transverse childhood to motherhood. Women who experienced either childhood abuse or p-IPV violence were more likely to experience negative emotional childbirth memories [ARR 1.21, 95 % CI (1.04, 1.39)]. Evidence also suggested that not continuing to exclusively breastfeed at 3 months post-partum was strongly associated with prenatal depression, young age, and perceived low social status during pregnancy. Perceived strong connectedness among extended family members and social networks (i.e. nexus among family, friends, and neighborhood) provided a buffering effect by preventing EBF termination. ConclusionThis research provides insights into the protective role of social connectedness in improving breastfeeding practice. It is vital to establish wholistic antenatal care and social service system to offer specialized support and response for victims of violence and mitigate the long-term sequelae of traumatic events.

Intimate Partner Violence and Breastfeeding Behaviors: Does the Source of Breastfeeding Information Affect the Associations Between Prepregnancy or Prenatal IPV and Breastfeeding Behaviors of Women in the United States? A PRAMS 2018 Study.

Background: Most countries do not meet World Health Organization's breastfeeding recommendations, and exposure to intimate partner violence (IPV) hinders positive breastfeeding behaviors. One in four U.S. women (43.6 million women) experiences IPV. This study aims to assess relationships between IPV, and breastfeeding initiation, duration, and early cessation among women in 42 U.S. states; and to evaluate possible modifying effect(s) of different breastfeeding information sources. Methods: Centers for Disease Control and Prevention's 2016-2018 Pregnancy Risk Assessment Monitoring System data (n = 105,230) were used to assess relationships between prepregnancy/prenatal IPV and breastfeeding initiation, duration, and early cessation; and modify effects of various breastfeeding information sources on study associations using multilogistic regression models. Results: About 1.4% of women experienced prenatal IPV with reduced odds of breastfeeding for 6 months or more (odds ratio [OR] = 0.74; 95% confidence interval = 0.58-0.94). Receiving breastfeeding information from baby's doctor modified early cessation (0.37 [0.18-0.78]) (p for interaction = 0.009) with prenatal IPV exposure. Among women exposed to prenatal IPV, breastfeeding initiation was stronger in women who received breastfeeding information from family/friends (2.46, [1.24-4.88]) (p for interaction = 0.010) or from breastfeeding support groups (3.03 [1.17-7.88]) (p for interaction = 0.023) compared to those who did not. Breastfeeding information from family/friends modified association between prepregnancy IPV and breastfeeding duration (0.67 [0.45-0.99]) (p for interaction = 0.042). Conclusions: Prenatal IPV is a risk factor for short-duration breastfeeding. Receiving information from doctors, nurses, support groups, and family/friends may improve breastfeeding behavior among IPV-exposed women. Interventions promoting breastfeeding information dissemination by family/friends, support groups, and doctors/nurses during hospital visits are encouraged.

Intergenerational effects of violence on women\u2019s perinatal wellbeing and infant health outcomes: evidence from a birth cohort study in Central Vietnam

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.

The impact of prenatal maternal stress due to potentially traumatic events on child temperament: A systematic review.

The objective of the current study was to complete a systematic review of the relationship between prenatal maternal stress due to potentially traumatic events (PTEs) and child temperament. Eligible studies through June 2020 were identified utilizing a search strategy in PubMed and PsycInfo. Included studies examined associations between prenatal maternal stress due to PTE and child temperament. Two independent coders extracted study characteristics and three coders assessed study quality. Of the 1969 identified studies, 20 met full inclusion criteria. Studies were classified on two dimensions: (1) disaster-related stress and (2) intimate partner violence during pregnancy. For disaster-related prenatal maternal stress, 75% (nine out of 12) of published reports found associations with increased child negative affectivity, 50% (five out of 10) also noted associations with lower effortful control/regulation, and 38% (three out of eight) found associations with lower positive affectivity. When considering prenatal intimate partner violence stress, 80% (four out of five) of published reports found associations with higher child negative affectivity, 67% (four out of six) found associations with lower effortful control/regulation, and 33% (one out of three) found associations with lower positive affectivity. Prenatal maternal stress due to PTEs may impact the offspring's temperament, especially negative affectivity. Mitigating the effects of maternal stress in pregnancy is needed in order to prevent adverse outcomes on the infant's socioemotional development.

1179Intergenerational Effects of Violence on Women’s Perinatal Wellbeing and Infant Health Outcomes in Vietnam

Abstract Background 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. Methods A birth cohort study in Hue City, Vietnam was conducted with 150 women in the third trimester of pregnancy (Wave 1) and three 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. Results One 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). Conclusions These 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. Key messages Mothers with violent and adverse family backgrounds have twice the risk of poor mental health during pregnancy, and their infants have twice the risk of adverse birth outcomes. Social support during pregnancy may have a buffering effect by reducing the long-term impact of childhood traumatic events.

Factors related to parenting confidence among pregnant women experiencing intimate partner violence.

Intimate partner violence (IPV) during pregnancy is associated with perinatal health problems and postpartum psychopathology. Prenatal IPV is also detrimental to a mother's perceptions of her unborn child, which may impact early parenting skills and contribute to negative effects on infant development. This study explored factors associated with parenting confidence among IPV-exposed pregnant women. Participants included 137 women who experienced IPV during pregnancy (Mage = 27.3 years; 66.9% African American/Black). Hierarchical linear regression modeling was used to examine factors that may be related to parenting confidence, with number of children and number of pregnancy complications entered in Model 1, adverse childhood experiences and IPV severity added in Model 2, and depressive symptoms and resilience added in Model 3. All models were significant, with the final model accounting for 23.2% of the variance in parenting confidence, F(6, 130) = 6.53, p < .001, R² = .23. In this model, having other children (β = .18, p = .023), fewer pregnancy complications (β = -.19, p = .019), and higher resilience (β = .33, p < .001) were associated with higher parenting confidence. Results suggest that intervention strategies that promote resilience and address pregnant women's health concerns may facilitate greater parenting confidence among IPV-exposed pregnant women. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Intimate partner violence during pregnancy is related to reduced birthweight: cross-sectional study in Kaduna, Northwestern Nigeria

Objective To determine the association of prenatal intimate partner violence (IPV) with birth weight. Methods A cross-sectional study of 320 mother-child pairs recruited shortly after birth at Barau Dikko Teaching Hospital, Kaduna, Nigeria. Emotional, physical, and sexual violence were measured after delivery using the Conflict Tactics Scale. The main outcome measure was birthweight in grams. Linear regression was used to estimate the adjusted associations (β and 95% confidence interval (CI)) between birthweight and 1) exposure to intimate partner violence (relative to no exposure), 2) frequency of prenatal IPV exposure. Results Sixty-nine percent of mothers experienced at least one of the three forms of IPV during pregnancy. Among term births, relative to the 31% of women with no IPV exposure, prenatal exposure to emotional violence was associated with a reduction in birthweight of 99g (95% CI -206,7), 182g (95% CI -285,-80) for physical violence and 139g (95% CI -247,-31) for sexual violence. The combination of all three forms of violence was associated with a 237g reduction in birthweight (95% CI -378,-96). Increasing instances of each of the three types of violence were associated with a greater reduction in birthweight. For physical violence, birthweight was lower by 121g (95% CI -227,-15) with 1-5 instances and 406g (95%CI -570, -240) for &gt;5 instances over the pregnancy, relative to no exposure to IPV. Conclusions Among term newborns, maternal exposure to any form of intimate prenatal violence was associated with reduced birth weight. A dose-response relationship was observed between intimate partner violence and birthweight.

Evidence for Better Lives Study: a comparative birth-cohort study on child exposure to violence and other adversities in eight low- and middle-income countries - foundational research (study protocol)

IntroductionViolence against children is a health, human rights and social problem affecting approximately half of the world’s children. Its effects begin at prenatal stages with long-lasting impacts on later health...

Intimate partner violence identified through routine antenatal screening and maternal and perinatal health outcomes

ABSTRACTBackgroundThis study investigated the association between intimate partner violence (IPV) identified on routine prenatal screening and perinatal outcomes for mother and infant.MethodsRoutinely collected perinatal data for a cohort of all women and their infants born in public health facilities in Sydney (Australia) over the period 2014–2016 (N = 52,509) were analysed to investigate the risk of adverse maternal and perinatal outcomes associated with a history of IPV. The association between an affirmative response on prenatal IPV screening and low birth weight (LBW) < 2.5 kg, preterm birth < 37 weeks, breastfeeding indicators and postnatal depressive symptoms (PND) was investigated in a series of logistic regression models.ResultsIPV was associated with an increased risk of PND (OR = 2.53, 95% CI 1.76–3.63), not breastfeeding at birth (OR = 1.65, 95% CI 1.30–2.09), non-exclusive breastfeeding at discharge (OR = 1.66, 95% CI 1.33–2.07) and first post-natal visit (OR = 1.54, 95% CI 1.24–1.91). Self-reported fear of a partner was strongly associated with an increased risk of PND (OR = 3.53, 95% CI 2.50–5.00), and also LBW (OR = 1.58, 95% CI 1.12–2.22), preterm birth (OR = 1.38, 95% CI 1.08–1.76), lack of early initiation of breastfeeding (OR = 1.67, 95% CI 1.28–2.17), non-exclusive breastfeeding at discharge from hospital (OR = 1.60, 95% CI 1.24–2.06) and at the first post-natal visit (OR = 1.27, 95% CI 0.99–3.04).ConclusionsIPV reported at the time of pregnancy was associated with adverse infant and maternal health outcomes. Although women may be disinclined to report IPV during pregnancy, universal, routine antenatal assessment for IPV is essential for early identification and appropriate management to improve maternal and newborn health.

Association between maternal psychological adversity and lung function in South African infants: A birth cohort study.

ObjectiveThe association of perinatal psychological adversity (ie, stressors and distress) with infant lung function (ILF) and development is not well studied in Africa and elsewhere. We determined the association between maternal perinatal psychological adversity and ILF in African infants.DesignProspective longitudinal follow up of the Drakenstein Child Health Study birth cohort.ParticipantsSeven hundred and sixty‐two infants aged 6 to 10 weeks and 485 infants who had data for both maternal perinatal psychological adversity and ILF (measured at 6 to 10 weeks and 12 months).MethodsThe main analyses were based on cross‐sectional measures of ILF at each assessment (6 to 10 weeks or 12 months), using generalized linear models, and then on the panel‐data of both longitudinal ILF assessments, using generalised estimating equations, that allowed specification of the within‐group correlation structure.ResultsPrenatal intimate partner violence (IPV) exposure was associated with reduced respiratory resistance at 6 to 10 weeks (beta coefficient [β] = −.131, P = .023); postnatal IPV with reduced ratio of time to peak tidal expiratory flow over total expiratory time (tPTEF/tE) at 12 months (β = −.206, P = .016); and prenatal depression with lower respiratory rate at 6 to 10 weeks (β = −.044, P = .032) and at 12 months (β = −.053, P = .021). Longitudinal analysis found an association of prenatal IPV with reduced tPTEF/tE (β = −.052, P < .0001); postnatal IPV with decreased functional residual capacity (FRC; β = −.086, P < .0001); prenatal posttraumatic stress disorder with increased FRC (β = .017, P < .0001); prenatal depression with increased FRC (β = .026, P < .0001) and postnatal depression with increased FRC (β = .021, P < .0001).ConclusionScreening for psychological adversity and understanding the mechanisms involved may help identify children at risk of altered lung development and inform approaches to treatment.

Intimate Partner Violence Before and During Pregnancy, and Prenatal Counseling Among Women with a Recent Live Birth, United States, 2009-2015.

Background: Intimate partner violence (IPV) is a leading cause of injury for reproductive-aged women. Clinical guidelines exist to assist providers in counseling women for IPV, but information on provider counseling among pregnant women from population-based sources is limited. Materials and Methods: Data for 2009-2015 from 37 states and New York City participating in the Pregnancy Risk Assessment Monitoring System (PRAMS) were analyzed (n = 258,263). We compared prevalence estimates overall and by site, of physical IPV occurring before and/or during pregnancy, and prenatal counseling on physical IPV. Multivariable logistic regression was used to identify factors associated with receiving prenatal counseling on physical IPV. Results: Overall, 3.8% of women reported experiencing any physical IPV in the 12 months before and/or during pregnancy (range: 1.5% [Connecticut] to 7.2% [Mississippi]). Prevalence of prenatal IPV counseling was 51.0% (range: 30.2% [Utah] to 63.1% [New Mexico]). Receipt of prenatal counseling on depression predicted a fourfold increase in prevalence of receiving counseling on physical IPV (adjusted prevalence ratio [aPR] = 4.20, 95% confidence interval [CI]: 4.06-4.34). In addition, non-Hispanic black race versus non-Hispanic white race, and having less than a high school education were associated with higher prevalence of receipt of IPV counseling ([aPR = 1.16, 95% CI: 1.14-1.18] and [aPR = 1.11, 95% CI: 1.08-1.13], respectively). Conclusion: Almost 4% of women with a recent live birth reported physical IPV before and/or during pregnancy. Only half of women received counseling on IPV during prenatal care, with counseling rates varying widely among states. Increased adherence to guidelines for universal screening and counseling of women could ensure all women are offered appropriate support and referral.

Prenatal intimate partner violence exposure predicts infant biobehavioral regulation: Moderation by the brain-derived neurotrophic factor (BDNF) gene - CORRIGENDUM.

The ability to regulate stress is a critical developmental milestone of early childhood that involves a set of interconnected behavioral and physiological processes and is influenced by genetic and environmental stimuli. Prenatal exposure to traumatic stress and trauma, including intimate partner violence (IPV), increases risk for offspring biobehavioral regulation problems during childhood and adolescence. Although individual differences in susceptibility to prenatal stress have been largely unexplored, a handful of studies suggest children with specific genetic characteristics are most vulnerable to prenatal stress. We evaluated the brain-derived neurotrophic factor Val66Met gene (BDNF) as a moderator of the effect of prenatal IPV exposure on infant temperamental and cortisol regulation in response to a psychosocial challenge. Ninety-nine mother-infant dyads recruited from the community were assessed when infants (51% female) were 11 to 14 months. Maternal reports of IPV during pregnancy and infant temperament were obtained, and infant saliva was collected for genotyping and to assess cortisol reactivity (before and after the Strange Situation Task). Significant genetic moderation effects were found. Among infants with the BDNF Met allele, prenatal IPV predicted worse temperamental regulation and mobilization of the cortisol response, while controlling for infant postnatal exposure to IPV, other maternal traumatic experiences, and infant sex. However, prenatal IPV exposure was not associated with temperamental or cortisol outcomes among infant carriers of the Val/Val genotype. Findings are discussed in relation to prenatal programming and biological susceptibility to stress.

The moderating effects of traumatic stress on vulnerability to emotional distress during pregnancy.

Emotional distress during pregnancy is likely influenced by both maternal history of adversity and concurrent prenatal stressors, but prospective longitudinal studies are lacking. Guided by a life span model of pregnancy health and stress sensitization theories, this study investigated the influence of intimate partner violence (IPV) during pregnancy on the association between childhood adversity and prenatal emotional distress. Participants included an urban, community-based sample of 200 pregnant women (aged 18-24) assessed annually from ages 8 to 17 for a range of adversity domains, including traumatic violence, harsh parenting, caregiver loss, and compromised parenting. Models tested both linear and nonlinear effects of adversity as well as their interactions with IPV on prenatal anxiety and depression symptoms, controlling for potential confounds such as poverty and childhood anxiety and depression. Results showed that the associations between childhood adversity and pregnancy emotional distress were moderated by prenatal IPV, supporting a life span conceptualization of pregnancy health. Patterns of interactions were nonlinear, consistent with theories conceptualizing stress sensitization through an "adaptive calibration" lens. Furthermore, results diverged based on adversity subdomain and type of prenatal IPV (physical vs. emotional abuse). Findings are discussed in the context of existing stress sensitization theories and highlight important avenues for future research and practice.

Does Prenatal Stress Shape Postnatal Resilience? - An Epigenome-Wide Study on Violence and Mental Health in Humans.

Stress during pregnancy widely associates with epigenetic changes and psychiatric problems during childhood. Animal studies, however, show that under specific postnatal conditions prenatal stress may have other, less detrimental consequences for the offspring. Here, we studied mental health and epigenome-wide DNA methylation in saliva following intimate partner violence (IPV) during pregnancy in São Gonçalo, a Brazilian city with high levels of violence. Not surprisingly, mothers exposed to pregnancy IPV expressed elevated depression, PTSD and anxiety symptoms. Children had similar psychiatric problems when they experienced maternal IPV after being born. More surprisingly, when maternal IPV occurred both during (prenatal) and after pregnancy these problems were absent. Following prenatal IPV, genomic sites in genes encoding the glucocorticoid receptor (NR3C1) and its repressor FKBP51 (FKBP5) were among the most differentially methylated and indicated an enhanced ability to terminate hormonal stress responses in prenatally stressed children. These children also showed more DNA methylation in heterochromatin-like regions, which previously has been associated with stress/disease resilience. A similar relationship was seen in prenatally stressed middle-eastern refugees of the same age as the São Gonçalo children but exposed to postnatal war-related violence. While our study is limited in location and sample size, it provides novel insights on how prenatal stress may epigenetically shape resilience in humans, possibly through interactions with the postnatal environment. This translates animal findings and emphasizes the importance to account for population differences when studying how early life gene–environment interactions affects mental health.