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.
Abstract:
Intimate partner violence (IPV) has been linked to poor fetal and infant growth. However, factors underlying this relationship are not well understood, particularly in the postnatal time period. In a South African cohort, we investigated (1) associations between IPV in pregnancy and growth at birth as well as postnatal IPV and child growth at 12 months and (2) whether maternal depression, tobacco or alcohol use or infant hospitalizations mediated IPV-growth relationships. Mothers were enrolled in pregnancy. Maternal IPV was measured during pregnancy and 10 weeks postpartum; depression, alcohol and tobacco use were measured during pregnancy and at 6 months postpartum. Child weight and length were measured at birth and 12 months and converted to z-scores for analysis. Linear regression and structural equation models investigated interrelationships between IPV and potential mediators of IPV-growth relationships. At birth, among 1,111 mother-infant pairs, maternal emotional and physical IPV were associated with reduced weight-for-age z-scores (WFAZ). Only physical IPV was associated with length-for-age z-scores (LFAZ) at birth. Antenatal maternal alcohol and tobacco use mediated IPV-growth relationships at birth. Postnatally, among 783 mother-infant pairs, emotional and physical IPV were associated with reduced WFAZ at 12 months. Only emotional IPV was associated with LFAZ at 12 months. Maternal tobacco use was a mediator postnatally. Findings highlight the role of physical and emotional IPV as risk factors for compromised fetal and infant growth. Findings underscore the importance of programmes to address interrelated risk factors for compromised infant growth, specifically IPV and substance use, which are prevalent in high-risk settings.
Related Concept Videos
Socioemotional Development during Infancy
Primary Temperament Types
Socioemotional Experience and Gender Development
Relationship Formation
Relationship with Parents: Attachment
Impact of Social Context on Individuals
Aggression


