Intimate partner violence and early child growth: a community-based cohort study in Nicaragua

Abstract

BackgroundThis study analyses whether a mother’s exposure to different forms of Intimate Partner Violence (IPV) during pregnancy was associated with the index child linear growth, and whether these associations were modified by the gender of the child.MethodsA pregnancy cohort of 478 women in León, Nicaragua, resulted in 461 live births. From this group, 81% (375/461) children were available for anthropometric follow-up at 40 to 46 months. Analysis of covariance (ANCOVA) was used to assess the association between IPV and height-for-age Z-scores, adjusting for confounding factors.ResultsSixty-three percent (236/375) of the mothers had been exposed to some form of IPV during pregnancy (emotional, physical, sexual or controlling behavior). After adjustment for confounding factors, maternal exposure to any IPV during pregnancy was associated with 0.24 lower mean height-for-age Z-scores (p = 0.02). A separate analysis of each IPV type showed that emotional, physical or sexual IPV during pregnancy were not significantly associated with lower mean height-for-age Z-scores, whereas ever exposure to controlling behavior by the father of the child was related to 0.29 lower mean height-for-age Z-scores (p < 0.01) When stratified by gender, these associations remained significant only for young girls.ConclusionsThis study has contributed to the growing amount of evidence pointing to the pervasive effect of different forms of IPV on child health. Our study highlights the relevance of maternal autonomy for linear child growth, especially for young girls in the Nicaraguan context.

Intimate Partner Violence and Failure to Thrive in Children Less than Two Years of Age

“…Another study revealed that adjusting for demographics reduced the strength of association for undernutrition but remained marked for wasting and stunting ). Yet another study found that after adjusting for maternal age, marital status, parity, residency and social economic status, stunting was still significant (Salazar et al, 2012). These findings insinuate that IPV alone has an impact on child's undernutrition, wasting and stunting and that maternal demographic factors may contribute to the severity of the child growth failures.…”

“…Higher education and decision-making among mothers were associated with higher WHZ, HAZ, and WAZ scores implying that these children were growing normally or tended towards obesity . A number of studies found low maternal education level associated with low Z-scores Salazar et al, 2012).…”

“…Previous studies Rico et al, 2011;Salazar et al, 2012) found significant difference in mothers' age during current pregnancy, mothers' ability to make decisions in the family, education level, Basal Metabolic Index (BMI), family's economic status, religion, place of residence , total household members, age at which the mother was first married and the number of pregnancies the mother has had and abuse status. These studies also found a difference based on mothers exposure to abuse in child's birth weight, height, wasting, stunting, under nutrition and anemia.…”

“…There was a positive correlation between parental use of illicit drug and alcohol and the likelihood of IPV , multiple incidence of violence was related to low maternal BMI and anemia ; young mothers were more likely to be abused (Rico et al, 2011;Salazar et al, 2012;Ziaei et al, 2014); women with low education level, limited decision making and low economic status and living in rural areas were more likely to be abused (Rico et al, 2011;Salazar et al, 2012;Sethuraman, Lansdown, & Sullivan, 2006;Ziaei et al, 2014). .…”

“…Another study found older age to be protective of undernutrion . A number of studies found that children of younger mothers had lower Z-scores Rico et al, 2011;Salazar et al, 2012).…”