Objective Assess the mental health, physical health, cognitive and language development of 10-year old children in families where mothers have reported intimate partner violence (IPV) compared with children with no reported IPV exposure.
Design Prospective pregnancy cohort. Maternal report of IPV (Composite Abuse Scale) at 1, 4 and 10 years. Maternal and direct assessment of child mental health (probable psychiatric diagnosis, anxiety and emotional/behavioural difficulties), cognition (IQ and executive function), language (general, pragmatic and receptive) and physical health at 10 years.
Setting A subsample of 615 mother–child dyads drawn from a pregnancy cohort of 1507 nulliparous women recruited from six public hospitals in Melbourne, Australia.
Results Any IPV exposure from infancy to age 10 was associated with poorer child outcomes at age 10. Specifically, twice the odds of a probable psychiatric diagnosis, emotional/behavioural difficulties, impaired language skills (general and pragmatic), and having consulted a health professional about asthma or sleep problems. IPV exposure at age 10 associated with two to three times higher odds of all mental health outcomes, elevated blood pressure and sleep problems. Early life exposure alone (at 1 and/or 4 years) associated with three times higher odds of a general language problem and asthma at age 10.
Conclusion The high prevalence of IPV and increased risk of poorer health and development among children exposed highlights the burden of ill health carried by children in families experiencing IPV. Fewer difficulties where exposure was limited to the early years builds the case for better identification, understanding and resourcing of effective early intervention.
- child abuse
- social work
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Contributors DG contributed to the study design, data collection, conducted analysis and wrote the paper; LJC conducted the analysis and contributed to the writing and editing of the manuscript; RG contributed to the study design, data collection, data analysis, writing and editing the manuscript; FKM contributed to the study design, data analysis and editing of the manuscript; KH, HH, SR, JN and ES contributed to the study design and edited the manuscript; FC contributed to the analyses and edited the manuscript; SJB conceived of the study and study design, contributed to data analysis and edited the manuscript.
Funding The Maternal Health Study was supported by project grants from the Australian National Health and Medical Research Council (NHMRC; #199222, #433006 and #491205) and Australian Rotary Health. Stephanie Brown holds an NHMRC Senior Research Fellowship (#1103976). Rebecca Giallo, Fiona Mensah and Emma Sciberras hold NHMRC Career Development Fellowships (#1123900, #1111160 and #1110688). Emma Sciberras holds a Veski Inspiring Women’s Fellowship. Harriet Hiscock holds an NHMRC Practitioner fellowship (#1136222). Deirdre Gartland and Laura Conway are supported by the NHMRC Safer Families Centre (#1116690). Laura Conway and Fallon Cook hold Lifecourse Postdoctoral Fellowships supported by the Royal Children’s Hospital Research Foundation. Research at the Murdoch Children’s Research Institute is supported by the Victorian Government Operational Infrastructure Support Programme.
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval Ethics approval was obtained through La Trobe University (2002/38), Royal Women’s Hospital (2002/23), Southern Health (2002-099B), Angliss Hospital and the Royal Children’s Hospital, (27056A, 33127A, 34058A and 36189A) Melbourne, Australia.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information. Further information about the Maternal Health Study can be obtained from the LifeCourse website (https://lifecourse.melbournechildrens.com/). The Maternal Health Study data are not open access. Requests for collaboration can be sent to Professor Brown (firstname.lastname@example.org) and will be considered by the Maternal Health Study investigative team.
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