scholarly journals Intergenerational effects of violence on women’s perinatal wellbeing and infant health outcomes: evidence from a birth cohort study in Central Vietnam

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Huyen Phuc Do ◽  
Philip R. A. Baker ◽  
Thang Van Vo ◽  
Aja Murray ◽  
Linda Murray ◽  
...  

Abstract Background Girls 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. Methods A 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. 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). Conclusion 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.

2021 ◽  
Author(s):  
Phuc Huyen Do ◽  
Philip RA Baker ◽  
Van Thang Vo ◽  
Aja Murray ◽  
Linda Murray ◽  
...  

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). Conclusion: 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.


2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Phuc Huyen Do ◽  
Philip Baker ◽  
Van Thang Vo ◽  
Xuan Bach Tran ◽  
Michael Dunne

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.


2019 ◽  
Vol 96 ◽  
pp. 255-265 ◽  
Author(s):  
Huyen Phuc Do ◽  
Bach Xuan Tran ◽  
Cuong Tat Nguyen ◽  
Thang Van Vo ◽  
Philip R.A. Baker ◽  
...  

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jing Li ◽  
Jie Qiu ◽  
Ling Lv ◽  
Baohong Mao ◽  
Lei Huang ◽  
...  

Abstract Background Many maternal factors are known to be associated with adverse birth outcomes, but studies about paternal factors yielded inconsistent conclusions. The study was to assess whether paternal factors are associated with low birth weight (LBW), preterm birth (PTB), and small for gestational age (SGA). Methods A birth cohort study was conducted in 2010–2012 at the Gansu Provincial Maternity and Child Care Hospital, the largest maternity and childcare hospital in Lanzhou, China. Paternal age, ethnicity, educational level, height, weight, smoking, and drinking were collected. Birth outcomes and pregnancy complications were extracted from the medical records. Results During the study period, 10,121 participants were included; the overall prevalence of LBW, PTB, and SGA was 7.2, 9.9, and 7.8%, respectively. Paternal higher height (OR = 0.64 95%CI: 0.49, 0.83), higher weight (P for trend < 0.001), and higher BMI (P for trend < 0.001) could decrease the rate of LBW. Paternal higher education (OR = 0.55, 95%CI: 0.43, 0.71) and higher weight (P for trend < 0.001,) were associated with lower rate of PTB. Fathers who smoked more than 6 pack-years were associated with PTB (OR = 1.31, 95%CI: 1.07, 1.61). Paternal BMI > 23.9 kg/m2 (P for trend < 0.001,) and paternal education which above college (OR = 0.61, 95%CI: 0.50, 0.82) were associated with a lower rate of SGA. Conclusion Paternal low education is independently associated with PTB and SGA. Paternal heavy smoking is associated with PTB. Low paternal weight/BMI is independently associated with LBW, PTB, and SGA.


2020 ◽  
Vol 17 (3) ◽  
pp. 56-59 ◽  
Author(s):  
Mwawi Ng'oma ◽  
Tesera Bitew ◽  
Malinda Kaiyo-Utete ◽  
Charlotte Hanlon ◽  
Simone Honikman ◽  
...  

Africa is a diverse and changing continent with a rapidly growing population, and the mental health of mothers is a key health priority. Recent studies have shown that: perinatal common mental disorders (depression and anxiety) are at least as prevalent in Africa as in high-income and other low- and middle-income regions; key risk factors include intimate partner violence, food insecurity and physical illness; and poor maternal mental health is associated with impairment of infant health and development. Psychological interventions can be integrated into routine maternal and child healthcare in the African context, although the optimal model and intensity of intervention remain unclear and are likely to vary across settings. Future priorities include: extension of research to include neglected psychiatric conditions; large-scale mixed-method studies of the causes and consequences of perinatal common mental disorders; scaling up of locally appropriate evidence-based interventions, including prevention; and advocacy for the right of all women in Africa to safe holistic maternity care.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Kerina Duri ◽  
◽  
Felicity Z. Gumbo ◽  
Privilege T. Munjoma ◽  
Precious Chandiwana ◽  
...  

Abstract Background Commencing lifelong antiretroviral therapy (ART) immediately following HIV diagnosis (Option B+), has greatly improved maternal-infant health. Thus, large and increasing numbers of HIV-infected women are on ART during pregnancy, a situation concurrently increasing numbers of HIV-exposed-uninfected (HEU) infants. Compared to their HIV-unexposed-uninfected (HUU) counterparts, HEU infants show higher rates of adverse birth outcomes, mortality, infectious/non-communicable diseases including impaired growth and neurocognitive development. There is an urgent need to understand the impact of HIV and early life ART exposures, immune-metabolic dysregulation, comorbidities and environmental confounders on adverse paediatric outcomes. Methods Six hundred (600) HIV-infected and 600 HIV-uninfected pregnant women ≥20 weeks of gestation will be enrolled from four primary health centres in high density residential areas of Harare. Participants will be followed up as mother-infant-pairs at delivery, week(s) 1, 6, 10, 14, 24, 36, 48, 72 and 96 after birth. Clinical, socio-economic, nutritional and environmental data will be assessed for adverse birth outcomes, impaired growth, immune/neurodevelopment, vertical transmission of HIV, hepatitis-B/C viruses, cytomegalovirus and syphilis. Maternal urine, stool, plasma, cord blood, amniotic fluid, placenta and milk including infant plasma, dried blood spot and stool will be collected at enrolment and follow-up visits. The composite primary endpoint is stillbirth and infant mortality within the first two years of life in HEU versus HUU infants. Maternal mortality in HIV-infected versus -uninfected women is another primary outcome. Secondary endpoints include a range of maternal and infant outcomes. Sub-studies will address maternal stress and malnutrition, maternal-infant latent tuberculosis, Helicobacter pylori infections, immune-metabolomic dysregulation including gut, breast milk and amniotic fluid dysbiosis. Discussion The University of Zimbabwe-College of Health-Sciences-Birth-Cohort study will provide a comprehensive assessment of risk factors and biomarkers for HEU infants’ adverse outcomes. This will ultimately help developing strategies to mitigate effects of maternal HIV, early-life ART exposures and comorbidities on infants’ mortality and morbidity. Trial registration ClinicalTrial.gov Identifier: NCT04087239. Registered 12 September 2019.


2020 ◽  
pp. 1-46
Author(s):  
Janet Currie ◽  
Michael Mueller-Smith ◽  
Maya Rossin-Slater

We study the effects of prenatal exposure to violent crime on infant health, using New York City crime records linked to mothers' addresses in birth records data. We address endogeneity of assault exposure with three strategies and find that in utero assault exposure significantly increases the incidence of adverse birth outcomes. We calculate that the annual social cost of assault during pregnancy in the US is more than $3.8 billion. Since infant health predicts long-term wellbeing and disadvantaged women are disproportionately likely to be domestic abuse victims, violence in utero may be an important channel for intergenerational transmission of inequality.


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