title: Intimate partner violence: associations with low infant birthweight in a South African birth cohort.
abstract: Violence against women is a global public health problem. Exposure to intimate partner violence (IPV) during pregnancy has been associated with a number of adverse maternal and fetal outcomes, including delivery of a low birthweight (LBW) infant. However, there is a paucity of data from low-middle income countries (LMIC). We examined the association between antenatal IPV and subsequent LBW in a South African birth cohort. This study reports data from the Drakenstein Child Lung Health Study (DCLHS), a multidisciplinary birth cohort investigation of the influence of a number of antecedent risk factors on maternal and infant health outcomes over time. Pregnant women seeking antenatal care were recruited at two different primary care clinics in a low income, semi-rural area outside Cape Town, South Africa. Antenatal trauma exposure was assessed using the Childhood Trauma Questionnaire (CTQ) and an IPV assessment tool specifically designed for the purposes of this study. Potential confounding variables including maternal sociodemographics, pregnancy intention, partner support, biomedical and mental illness, substance use and psychosocial risk were also assessed. Bivariate and multiple regression analyses were performed to determine the association between IPV during pregnancy and delivery of an infant with LBW and/or low weight-for-age z (WAZ) scores. The final study sample comprised 263 mother-infant dyads. In multiple regression analyses, the model run was significant [r2  = 0.14 (adjusted r2  = 0.11, F(8, 212) = 4.16, p = 0.0001]. Exposure to physical IPV occurring during the past year was found to be significantly associated with LBW [t = -2.04, p = 0.0429] when controlling for study site (clinic), maternal height, ethnicity, socioeconomic status, substance use and childhood trauma. A significant association with decreased WAZ scores was not demonstrated. Exposure of pregnant women to IPV may impact newborn health. Further research is needed in this field to assess the relevant underlying mechanisms, to inform public health policies and to develop appropriate trauma IPV interventions for LMIC settings.
authors.affiliation: Department of Psychiatry, Groote Schuur Hospital (J2), University of Cape Town, Cape Town, South Africa, nastassja.koen@gmail.com.
authors.forename: Nastassja
authors.initials: N
authors.lastname: Koen
authors.forename: Gail E
authors.initials: GE
authors.lastname: Wyatt
authors.forename: John K
authors.initials: JK
authors.lastname: Williams
authors.forename: Muyu
authors.initials: M
authors.lastname: Zhang
authors.forename: Landon
authors.initials: L
authors.lastname: Myer
authors.forename: Heather J
authors.initials: HJ
authors.lastname: Zar
authors.forename: Dan J
authors.initials: DJ
authors.lastname: Stein
mesh_terms: D000293:Adolescent; D000328:Adult; D002649:Child Abuse / Q000191:economics / Q000523:psychology / Q000639:trends*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight / Q000502:physiology* / Q000523:psychology; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D012307:Risk Factors; D012959:Socioeconomic Factors; D013019:South Africa / Q000453:epidemiology; D013179:Spouse Abuse / Q000191:economics / Q000523:psychology / Q000639:trends*; D011795:Surveys and Questionnaires; D055815:Young Adult
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