Intimate partner violence and growth outcomes through infancy: A longitudinal investigation of multiple mediators in

Whitney Barnett1,2, Raymond Nhapi1, Heather J Zar1

  • 1Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, and SA-Medical Research Council Unit on Child and Adolescent Health, University of Cape Town, Cape Town, South Africa.

Insights

Intimate partner violence (IPV) during pregnancy and postpartum is linked to poorer infant growth. Maternal substance use partially explains this connection, highlighting the need for integrated support programs.

Area of Science:

  • Public Health
  • Maternal and Child Health
  • Psychology

Background:

  • Intimate partner violence (IPV) is a known risk factor for adverse fetal and infant outcomes.
  • The specific pathways linking IPV to growth deficits, especially in the postnatal period, require further elucidation.
  • Understanding mediating factors is crucial for developing effective interventions.

Purpose of the Study:

  • To examine associations between antenatal and postnatal IPV and infant growth at birth and 12 months.
  • To investigate the mediating roles of maternal depression, alcohol use, tobacco use, and infant hospitalizations in the IPV-growth relationship.
  • To explore these relationships within a South African cohort.

Main Methods:

  • Longitudinal study design enrolling mothers during pregnancy.
  • Measurement of maternal IPV (emotional and physical) during pregnancy and postpartum.
  • Assessment of maternal depression, alcohol and tobacco use, and infant anthropometric measurements (weight and length z-scores) at birth and 12 months.
  • Statistical analyses using linear regression and structural equation modeling.

Main Results:

  • Antenatal emotional and physical IPV were associated with reduced birth weight-for-age z-scores (WFAZ).
  • Physical IPV was linked to reduced length-for-age z-scores (LFAZ) at birth.
  • Postnatal emotional and physical IPV were associated with reduced WFAZ at 12 months.
  • Emotional IPV was linked to reduced LFAZ at 12 months.
  • Maternal alcohol and tobacco use mediated IPV-growth relationships at birth; tobacco use mediated postnatal relationships.

Conclusions:

  • Physical and emotional IPV are significant risk factors for compromised fetal and infant growth.
  • Maternal substance use (alcohol and tobacco) plays a mediating role in the relationship between IPV and infant growth.
  • Interventions addressing both IPV and substance use are critical for improving infant growth in high-risk settings.

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