Correlation of domestic violence during pregnancy with plasma amino-acid neurotransmitter, cortisol levels and catechol-o-methyltransferase Val(158)Met polymorphism in neonates

The lasting impact of family and domestic violence on neonatal health outcomes

OBJECTIVES

To compare the health of neonates born to women who experienced family and domestic violence (FDV) 12 months prior to birth, with the health of neonates born to women with an earlier history of FDV and women with no history of FDV.

METHODS

A retrospective cohort of women who experienced FDV within 12 months of birth (antenatal FDV [AFDV]) (n = 1230) was identified using data from the Western Australia (WA) Police Force Incident Management System and WA Hospital Morbidity Data Collection. Two comparison cohorts were used, the first including women with a history of FDV (HFDV) 12-60 months prior to birth (n = 1549) and the second with no history of FDV (NFDV) recorded (n = 3690). Hospital, birth, mortality, and congenital anomaly data were used in generalized linear models to examine and compare neonatal health outcomes.

RESULTS

Women in the AFDV group had higher proportions of factors associated with poor neonatal outcomes including smoking (42.4%), substance use (23.0%), and mental health disorders (34.8%). Neonates born to AFDV mothers had significantly higher odds of congenital anomalies (OR: 1.51, 95% CI: 1.18-1.94), low birth weight (1.74, 1.45-2.10), and preterm birth (1.48, 1.22-1.79) compared with neonates born to NFDV mother. Neonatal health outcomes in those born to AFDV women were not significantly different from those born to HFDV women.

CONCLUSIONS

Antenatal and historical FDV were associated with poor neonatal health outcomes. Additional pregnancy and social support should be offered to women who have experienced FDV during or prior to pregnancy.

The Effect of Domestic Violence During Pregnancy on Cortisol Hormone Release, Breastfeeding, and Newborn

This study was conducted to determine the effect of domestic violence during pregnancy on the cortisol hormone release, preterm birth, low birth weight, and breastfeeding status. The cross-sectional study was conducted with 255 pregnant women in a Family Health Centre in the Southeastern Anatolia Region of Turkey between October 2017 and August 2018. The questionnaire, DVWDS (Domestic Violence to Women Determination Scale) and Breastfeeding Self-Efficacy Scale were used to collect the data. In the present study, the pregnant women were followed up three times. The first follow-up was applied to the pregnant women in the second trimester, the second follow-up was applied to those in the third trimester, and the third follow-up was applied to the postpartum women. At each follow-up from newborn, cortisol hormone level was taken with saliva and evaluated. It was determined that 9.8% of the pregnant women participating in the study were exposed to violence by their partners. An important result was found that those who were exposed to domestic violence during their pregnancy gave birth in the 37th week (p < 0.05). It was seen that the babies of those exposed to domestic violence during pregnancy had a higher mean cortisol hormone level (p < 0.05). It was found that the mean score of the Breastfeeding Self-Efficacy Scale in the third follow-up was lower for those who were exposed to domestic violence during pregnancy than those who were not (p < 0.05). It was observed during the pregnancy that domestic violence affected cortisol hormone secretion, breastfeeding after birth and newborn health.

An Increased Adverse Fetal Outcome Has Been Observed among Teen Pregnant Women in Rural Eastern Ethiopia: A Comparative Cross-Sectional Study

Background: According to the World Health Organization, teenage pregnancies are high-risk due to increased risks of fetal and infant morbidity and mortality. This study compares adverse fetal outcomes between teen and adult pregnant women from rural Eastern Ethiopia. Methods: Institutional-based cross-sectional study was conducted among women visiting maternity units from surrounding rural areas. A total of 481 teenagers (13-19 years old) and 481 adults (20-34 years old) women with a singleton pregnancy were included in the study. Two hospitals and 3 health centers were selected in Eastern Hararghe Zone, Eastern Ethiopia. Comparative analysis was carried out using the log-binomial regression model to identify factors associated with adverse fetal outcomes in both categories. The results are reported in adjusted prevalence ratios with 95% confidence intervals. Results: High proportion of adverse fetal outcome was observed among teenage women than adult (34.9% vs 21%). Statistically significant difference (P < .05) in the proportion of low birth weight (21.1% vs 9.3%), preterm birth (18.7% vs 10.6%), APGAR score at 5th minute (9.3% vs 4%) were found in teenagers compared to adult women. Antenatal care attendance (APR = 0.44; 95% CI: 0.23, 0.86); eclampsia (APR = 1.96; 95% CI: 1.26, 3.06); pre-eclampsia (APR = 1.73; 95% CI: 1.12, 2.67); and wealth index (rich) (APR = 0.55; 95% CI: 0.32, 0.94) were significantly associated with adverse fetal outcomes among the teenage women. Whereas intimate partner violence (APR = 2.22; 95% CI: 1.26, 3.90); preeclampsia (APR = 3.05; 95% CI: 1.61, 5.69); antepartum hemorrhage (APR = 2.77; 95% CI: 1.73, 4.46); and hyperemesis gravderm (APR = 1.75; 95% CI: 1.09, 2.79) were significantly associated with adverse fatal outcomes among the adult women. Conclusion: teenage pregnancy is associated with a high rate of adverse fetal outcomes. Early identification and treatment of problems during antenatal follow-up should be the mainstay to avert the massive adverse fetal effects.

Exposure to family and domestic violence is associated with increased childhood hospitalisations

Background

Children’s exposure to family and domestic violence (FDV) is a global public health concern and is considered one of the most common and severe stressors children can experience. While it is acknowledged that children who are exposed to FDV have poorer general health, there is a lack of data on the outcomes of children exposed to FDV. The use of longitudinal data has been suggested as a way to gain an understanding of the impact on children’s long-term outcomes.

Methods

Our cohort study used deidentified individual-level linked administrative data of children born 1987–2010, in Western Australia, who were exposed to FDV in the prenatal period (12 months prior to birth) to five years of age (early years).

Results

Children exposed to FDV are more likely to be hospitalised than non-exposed children. Children exposed to FDV in both the prenatal and early childhood period had a threefold increased odds of mental health hospitalisation. We found a significant increase in odds of pregnancy-related hospitalisation in FDV exposed children. When stratified by Aboriginal status, Aboriginal children had a higher proportion of hospitalisations than non-Aboriginal children.

Conclusion

Exposed children have an increased likelihood for hospitalisation than non-exposed children. Within the exposed cohort differences were apparent between Aboriginal and non-Aboriginal children. Aboriginal children had greater odds for hospitalisation in most of the diagnostic groups compared to their non-Aboriginal counterparts. Our findings represent an important advance in the literature with respect to the burden of disease of children exposed to FDV.

Association of intimate partner violence during pregnancy, prenatal depression, and adverse birth outcomes in Wuhan, China

Background

Intimate partner violence (IPV) among pregnant women constitutes a global public health problem and a potential risk factor for adverse maternal and fetal outcomes. The present study aimed to examine the associations among IPV during pregnancy, prenatal depression, and adverse birth outcomes in Wuhan, China.

Methods

A cross-sectional study was performed from April 2013 to March 2014 in Wuhan, China. Sociodemographic characteristics, IPV during pregnancy, and depressive symptoms during pregnancy were assessed in the third trimester of pregnancy. Birth outcomes were collected after delivery using medical records. Chi-square tests and logistic regression analysis were used to examine the association between IPV and prenatal depression, as well as the association between IPV combined with prenatal depression and adverse birth outcomes.

Results

After adjustment for covariates, there was a statistically significant association between IPV during pregnancy and prenatal depression (adjusted odds ratio [aOR] = 2.50, 95% confidence interval [CI]: 1.60–3.90). IPV during pregnancy (aOR = 1.67, 95% CI: 1.08–2.56) and prenatal depression (aOR = 1.72, 95% CI: 1.11–2.68) were significantly associated with adverse birth outcomes. Women experiencing psychological abuse had a significantly higher odds of prenatal depression (aOR = 2.04, 95% CI: 1.19–3.49) and of adverse birth outcomes (aOR = 2.13, 95% CI: 1.08–2.58), compared with women who did not experience IPV and prenatal depression.

Conclusions

IPV during pregnancy and prenatal depression were significantly associated with adverse birth outcomes, after adjustment for socio-demographic and behavior factors. The findings suggest that early recognition of IPV and prenatal depression during antenatal care may protect pregnant women and improve birth outcomes.

Association of phthalate exposures with urinary free cortisol and 8-hydroxy-2'-deoxyguanosine in early childhood

Several studies suggested potential links of phthalates to stress-related outcomes. However, limited evidence has been available for the relationships between phthalate metabolites and free cortisol and 8-hydroxy-2'-deoxyguanosine (8-OHdG) in perinatal and postnatal environments. Therefore, we evaluated the relationships between phthalate metabolites and free cortisol and 8-OHdG in mother-child pairs. We repeatedly collected urine samples of 287 mother-child pairs from just before delivery to 15 months of age to measure the levels of four phthalate metabolites - mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP), mono-isobutyl phthalate (MiBP), and mono-n-butyl phthalate (MnBP) - and free cortisol and 8-OHdG. We used linear mixed effect models and generalized additive mixed models to estimate the relationship between the phthalate metabolites and free cortisol and 8-OHdG after adjusting for the child's gender, urine collection time, and maternal smoking status. The four phthalate metabolite levels were strongly correlated each other (all, p < .0001), and intra-class correlation for each metabolite in children ranged from 0.18 to 0.96. All four phthalate metabolites were positively associated with both free cortisol (MEHHP, β = 0.18 and p < .0001; MEOHP, β = 0.17 and p < .0001; MiBP, β = 0.13 and p = .0001; MnBP, β = 0.21 and p < .0001; and molar sum of metabolites, β = 0.21 and p < .0001) and 8-OHdG (MEHHP, β = 0.20 and p < .0001; MEOHP, β = 0.18 and p < .0001; MiBP, β = 0.23 and p < .0001; MnBP, β = 0.28 and p < .0001; and molar sum of metabolites, β = 0.29 and p < .0001) in childhood. Our findings suggest that phthalate exposures increase free cortisol and 8-OHdG levels in early childhood.

The prevalence of sexual violence during pregnancy in Iran and the world: a systematic review and meta-analysis

Background:

Domestic violence during pregnancy is a public health crisis, because it affects both mother ‎and fetus simultaneously, resulting in irreversible consequences for mothers and their ‎newborns. This study was performed to determine the prevalence of sexual violence during ‎pregnancy in the world and Iran as meta-analysis.‎

Methods:

This study is a meta-analysis on the prevalence of sexual violence during pregnancy ‎in the world and Iran that was conducted on Persian and English published articles up to ‎‎2015. To this end, through searching the information by key words and their compounds at SID, Medlib, Irandoc, Google scholar, Pubmid, ‎ISI, Iranmedex, Scopus and Magiran, all related articles ‎were extracted independently by two trained researchers. The results of studies ana-lyzed using ‎the STATA and Spss16 software.‎

Results:

In the initial searching of 167 articles, 33 articles related to Iran, 40 articles related to ‎other parts of the world and totally 73 articles met inclusion criteria for study. The prevalence ‎of sexual violence during pregnancy were estimated in the world 17% (CI95%:15% -18%) and ‎in Iran 28% (CI95%: 23% -32%).The prevalence of sexual violence during pregnancy in Iran is ‎‎11 percent more than the world.‎

Conclusions:

According to the present meta-analysis results, the prevalence of sexual violence ‎during pregnancy in Iran is high. Given that sexual violence during pregnancy causes damage to ‎the mother and infant, it is recommended that the relevant authorities with the implementation ‎of intervention and educational programs reduce the prevalence of sexual violence during ‎pregnancy.‎

Association between Intimate Partner Violence during Pregnancy and Adverse Pregnancy Outcomes in Vietnam: A Prospective Cohort Study

Background

Violence against pregnant women is an increasing public health concern particularly in low- and middle-income countries. The purpose of this study was to measure the association between intimate partner violence (IPV) during pregnancy and the risk of adverse birth outcomes.

Methods

Prospective cohort study of 1276 pregnant women in Dong Anh district, Vietnam. Women with gestational age less than 24 weeks were enrolled and interviewed. Repeated interviews were performed at 30–34 weeks gestation to assess experience of IPV during pregnancy and again 48 hours post-delivery to assess the birth outcome including birth weight and gestational age at delivery.

Results

There was a statistically significant association between exposure to physical violence during pregnancy and preterm birth (PTB) or low birth weight (LBW). After adjustment for age, education, occupation, body mass index (BMI), haemoglobin level, previous adverse pregnancy outcomes, the pregnant women who were exposed to physical violence during pregnancy were five times more likely to have PTB (AOR = 5.5; 95%CI: 2.1–14.1) and were nearly six times more likely to give birth to a child of LBW (AOR = 5.7; 95%CI: 2.2–14.9) as compared to those who were not exposed to physical violence.

Conclusion

Exposure to IPV during pregnancy increases the risk of PTB and LBW. Case-finding for violence in relation to antenatal care may help protect pregnant women and improve pregnancy outcomes.

Correlation of maternal abuse during pregnancy with infant temperament and development

OBJECTIVE

To investigate the effects of domestic violence (DV) against pregnant women on their infant's development in China.

DESIGN

247 mothers were interviewed using the Chinese version of the Abuse Assessment Screen, and all participants underwent postnatal assessment with the Edinburgh Postpartum Depression Scale (EDPS). Plasma glutamate (Glu), γ-aminobutyric acid (GABA) and cortisol levels of the neonates were measured. After a 10-month follow-up, the infants were assessed using the Revised Infant Temperament Questionnaire (RITQ) and Bayley Scales of Infant Development (BSID).

RESULTS

86 infants of abused mothers (DV group) and 137 infants of non-abused mothers (non-DV group) completed the 10-month follow-up. Neonate levels of plasma Glu, GABA and cortisol were significantly higher in the DV group than in the non-DV group. Scores for the temperament factors, rhythmicity, approach/withdrawal, mood, distractibility and persistence, of the RITQ were rated significantly higher, and results for the Psychomotor Development Index (PDI) of the BSID were significantly lower in the DV group than in the non-DV group at 10 months. After adjustment for the EPDS as a covariate, only distractibility of the RITQ showed a statistically significant difference between the two groups. In correlation analysis, infant mood correlated significantly with levels of plasma Glu (β=0.2345) and GABA (β=0.2554), whether or not the EPDS scores were adjusted. Infant persistence and threshold of stimuli scores did not correlate significantly with DV during pregnancy after adjustment for the EPDS.

CONCLUSIONS

DV against pregnant women may be associated with impaired temperament and development in their infants.