Slopen Natalie, Zhang Jing, Urlacher Samuel S, De Silva Gretchen, Mittal Mona
Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, MD, United States.
Department of Anthropology, Hunter College, City University of New York, New York, NY, United States.
SSM Popul Health. 2018 Sep 10;6:107-115. doi: 10.1016/j.ssmph.2018.09.002. eCollection 2018 Dec.
Intimate partner violence (IPV) is a critical public health issue that impacts women and children across the globe. Prior studies have documented that maternal experiences of IPV are associated with adverse psychological and physical health outcomes in children; however, research on the underlying physiological pathways linking IPV to these conditions is limited. Drawing on data from the 2010 Tanzania Demographic and Health Survey, we examined the relationship between maternal report of IPV in the past 12 months and inflammation among children ages 6 months to 5 years. Our study included 503 children who were randomly selected to provide a blood sample and had a mother who had ever been married and who had completed the Domestic Violence Module, which collected information on physical, sexual, and emotional violence. Analyses were stratified based on a threshold for acute immune activation status, defined by the threshold of CRP > 1.1 mg/L for young children in Tanzania. In bivariate analyses, healthy children whose mothers reported IPV showed a marginally elevated median CRP level compared to children whose mothers did not report IPV (0.35 vs. 0.41 mg/L; p = 0.13). Similarly, among children with active or recent infections, those whose mothers reported IPV had an elevated median CRP compared to children whose mothers did not (4.06 vs 3.09 mg/L; p = 0.03). In adjusted multiple variable regression models to account for child, mother, and household characteristics, maternal IPV was positively associated with (log) CRP in both healthy children and children with active or recent infection. Although longitudinal research with additional biomarkers of inflammation is needed, our results provide support for the hypothesis that inflammation may function as a biological pathway linking maternal IPV to poor psychological and physical health outcomes among children of mothers who are victimized-and this may extend to very young children and children in non-Western contexts.
亲密伴侣暴力（IPV）是一个严重的公共卫生问题，影响着全球的妇女和儿童。先前的研究已证明，母亲遭受亲密伴侣暴力的经历与儿童不良的心理和身体健康结果相关；然而，关于将亲密伴侣暴力与这些状况联系起来的潜在生理途径的研究有限。利用2010年坦桑尼亚人口与健康调查的数据，我们研究了过去12个月母亲报告的亲密伴侣暴力与6个月至5岁儿童炎症之间的关系。我们的研究包括503名儿童，他们被随机挑选来提供血样，其母亲曾结过婚且完成了家庭暴力模块调查，该模块收集了有关身体暴力、性暴力和情感暴力的信息。分析根据急性免疫激活状态的阈值进行分层，该阈值由坦桑尼亚幼儿CRP>1.1mg/L的阈值定义。在双变量分析中，母亲报告遭受亲密伴侣暴力的健康儿童的CRP中位数略高于母亲未报告遭受亲密伴侣暴力的儿童（0.35 vs. 0.41mg/L；p = 0.13）。同样，在患有活动性或近期感染的儿童中，母亲报告遭受亲密伴侣暴力的儿童的CRP中位数高于母亲未报告遭受亲密伴侣暴力的儿童（4.06 vs 3.09mg/L；p = 0.03）。在调整了儿童、母亲和家庭特征的多变量回归模型中，母亲遭受亲密伴侣暴力与健康儿童以及患有活动性或近期感染的儿童的（对数）CRP呈正相关。尽管需要进行更多具有炎症生物标志物的纵向研究，但我们的结果支持了这样一种假设，即炎症可能是一条生物学途径，将母亲遭受的亲密伴侣暴力与受害母亲的子女不良的心理和身体健康结果联系起来——这可能也适用于幼儿和非西方背景下的儿童。
