Vulnerability to intimate partner violence and poor mental health in the first 4-year postpartum among mothers reporting childhood abuse: an Australian pregnancy cohort study
The purpose of this study was to investigate intergenerational patterns of abuse and trauma and the health consequences for women in the early childbearing years. A prospective pregnancy cohort of 1507 nulliparous women (≦24 weeks gestation) were recruited in Melbourne, Australia, 2003–2005. Follow-up was scheduled in late pregnancy, 3-, 6- and 12-month and 4-year postpartum. Childhood abuse was retrospectively reported at 4-year postpartum using the Child Maltreatment History Self Report. Intimate partner violence (IPV) was assessed at 1- and 4-year postpartum with the Composite Abuse Scale. Maternal depressive symptoms were assessed in all follow-ups using the Edinburgh Postnatal Depression Scale. Multivariable logistic regression was used to examine associations between childhood abuse, maternal mental health and IPV. Childhood abuse was reported by 41.1 % of women. In the 4 years after having their first child, 28.2 % of women reported IPV, 25.2 % depression and 31.6 % anxiety. Childhood abuse was associated with odds of depression or anxiety 1.5–2.6 times greater and 1.8–3.2 times greater for IPV. Childhood physical abuse remained significantly associated with depression and anxiety in pregnancy and postpartum after adjusting for IPV and stressful life events, while sexual abuse remained significantly associated only with anxiety. Women who begin childbearing with a history of childhood abuse are more vulnerable to IPV and poor mental health. All health care services and agencies in contact with children, young people and families should have adequate training to identify trauma associated with abuse and IPV and provide first line supportive care and referral.
KeywordsIntimate partner violence Maternal health Childhood abuse Cohort study
We are extremely grateful to all of the women taking part in the study, to the members of the Maternal Health Study Collaborative Group (Christine MacArthur, Kelsey Hegarty, Jane Gunn, Shaun Brennecke, PeterWein and Jane Yelland), who contributed to the design of study instruments and to the members of the Maternal Study Health Study research team, who have contributed to data collection and coding (Sue Perlen, Ann Krastev, Ellie McDonald, Marion Tait, Liesje Brice, Maggie Flood, Kay Paton, Renee Paxton and Martine Spaull). This research was supported by funding from The National Health and Medical Research Council (NHMRC) (Grant nos. 199222, 433006 and 491205); a VicHealth Research Fellowship (SB), an ARC Future Fellowship (SB), an NHMRC Caeer Development Fellowship no. 491205 (SB) and an NHMRC Early Career Fellowship no. 1037449 (FM); and a grant from the Medical Research and Technology in Victoria Fund (ANZ Trustees) and the Victorian Government’s Operational Infrastructure Support Program.
Compliance with ethical standards
Ethics approval was granted by La Trobe University (2002/38), Royal Women’s Hospital (2002/23), Southern Health (2002-099B), Angliss Hospital and The Royal Children’s Hospital (27056A).
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