Maternal intimate partner violence and increased asthma incidence in children: buffering effects of supportive caregiving.
OBJECTIVE
To examine the relationship between maternal intimate partner violence (IPV) and asthma onset in children and the role of supportive caregiving factors in modifying this relationship.


METHODS
Prospective birth cohort.


METHODS
In-person interview at enrollment as well as in-home interviews during study follow-up.


METHODS
Children (N = 3116) enrolled in the Fragile Families and Child Wellbeing Study. Main Exposures Maternal report of IPV assessed after the child's birth and at 12 and 36 months. In addition, mothers indicated how many days a week they participated in activities with the child and the amount and type of educational/recreational toys available for the child. Main Outcome Measure Maternal report of physician-diagnosed asthma by age 36 months.


RESULTS
Asthma was diagnosed in 19% of children. In adjusted analysis, children of mothers experiencing IPV chronically, compared with those not exposed, had a 2-fold increased risk of developing asthma. In stratified analysis, children of mothers experiencing IPV and low levels of mother-child activities (relative risk, 2.7; 95% confidence interval, 1.6-4.7) had a significant increased risk for asthma. Those exposed to IPV and high levels of mother-child activities had a lower risk for asthma (relative risk, 1.6; 95% confidence interval, 0.9-3.2). A similar buffering effect was noted among children with high numbers of educational/recreational toys.


CONCLUSIONS
Intimate partner violence is associated with increased early childhood asthma risk. Maternal ability to maintain positive caregiving processes in this context may buffer the effects of violence on child asthma risk. The best way to promote positive health in toddlers may be to help their mothers.
Suglia
Shakira Franco
SF
Department of Environmental Health, Harvard School of Public Health, Boston, MA 02215, USA. sfranco@hsph.harvard.edu
Enlow
Michelle Bosquet
MB
Kullowatz
Antje
A
Wright
Rosalind J
RJ
D001249:Asthma / Q000453:epidemiology* / Q000523:psychology*; D017028:Caregivers / Q000523:psychology*; D002675:Child, Preschool; D005163:Factor Analysis, Statistical; D005192:Family Health; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D009034:Mother-Child Relations; D009035:Mothers / Q000523:psychology*; D011446:Prospective Studies; D013179:Spouse Abuse / Q000523:psychology*