Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts;
Harborview Injury Prevention and Research Center, University of Washington, Seattle, Washington.
Pediatrics. 2020 Jun;145(6). doi: 10.1542/peds.2019-2955. Epub 2020 May 18.
Previous research has demonstrated associations between maternal experience of intimate partner violence (IPV) and a range of adverse outcomes among women and their young children. However, few studies have examined the associations between maternal experience of IPV and early child development (ECD) outcomes in low- and middle-income countries (LMIC). Our objectives in this study were to examine the association between IPV victimization and ECD and assess whether the association was mediated by maternal and paternal stimulation.
We combined cross-sectional data from the Demographic and Health Surveys for 15 202 households representing mothers and fathers of children aged 36 to 59 months in 11 LMIC. We used multivariable linear regression models to estimate the association between IPV victimization in the year preceding the survey and ECD, which we measured using the Early Child Development Index. We used path analysis to determine if the association between IPV victimization and ECD was mediated through maternal and paternal stimulation.
After adjusting for sociodemographic variables, IPV victimization was negatively associated with ECD (β = -.11; 95% confidence interval = -.15 to -.07). Path analysis indicated that the direct association between IPV victimization and ECD was partially and independently mediated through maternal and paternal stimulation.
Interventions that include components to prevent IPV may be effective for improving ECD in LMIC.
先前的研究表明,孕产妇经历亲密伴侣暴力(IPV)与女性及其幼儿的一系列不良后果之间存在关联。然而,很少有研究调查孕产妇经历 IPV 与中低收入国家(LMIC)幼儿发展(ECD)结果之间的关联。我们在这项研究中的目的是检验 IPV 受害与 ECD 之间的关联,并评估这种关联是否通过母婴刺激来介导。
我们结合了来自 11 个 LMIC 的 15202 个家庭的横断面数据,这些家庭代表了 36 至 59 个月大的儿童的母亲和父亲。我们使用多变量线性回归模型来估计在调查前一年中 IPV 受害与 ECD 之间的关联,我们使用早期儿童发展指数来衡量 ECD。我们使用路径分析来确定 IPV 受害与 ECD 之间的关联是否通过母婴刺激来介导。
在调整了社会人口学变量后,IPV 受害与 ECD 呈负相关(β=-.11;95%置信区间=-.15 至-.07)。路径分析表明,IPV 受害与 ECD 之间的直接关联部分且独立地通过母婴刺激来介导。
包括预防 IPV 内容的干预措施可能对改善 LMIC 的 ECD 有效。