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Antenatal maternal intimate partner violence exposure is associated with sex-specific alterations in brain structure among young infants: Evidence from a South African birth cohort.

ABSTRACT: Maternal psychological distress during pregnancy has been linked to adverse outcomes in children with evidence of sex-specific effects on brain development. Here, we investigated whether in utero exposure to intimate partner violence (IPV), a particularly severe maternal stressor, is associated with brain structure in young infants from a South African birth cohort. Exposure to IPV during pregnancy was measured in 143 mothers at 28-32 weeks' gestation and infants underwent structural and diffusion magnetic resonance imaging (mean age 3 weeks). Subcortical volumetric estimates were compared between IPV-exposed (n = 63; 52% female) and unexposed infants (n = 80; 48% female), with white matter microstructure also examined in a subsample (IPV-exposed, n = 28, 54% female; unexposed infants, n = 42, 40% female). In confound adjusted analyses, maternal IPV exposure was associated with sexually dimorphic effects in brain volumes: IPV exposure predicted a larger caudate nucleus among males but not females, and smaller amygdala among females but not males. Diffusivity alterations within white matter tracts of interest were evident in males, but not females exposed to IPV. Results were robust to the removal of mother-infant pairs with pregnancy complications. Further research is required to understand how these early alterations are linked to the sex-bias in neuropsychiatric outcomes later observed in IPV-exposed children.

SUBMITTER: Hiscox LV

PROVIDER: S-EPMC9929680 | biostudies-literature | 2023 Feb

REPOSITORIES: biostudies-literature

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Antenatal maternal intimate partner violence exposure is associated with sex-specific alterations in brain structure among young infants: Evidence from a South African birth cohort.

Hiscox Lucy V LV Fairchild Graeme G Donald Kirsten A KA Groenewold Nynke A NA Koen Nastassja N Roos Annerine A Narr Katherine L KL Lawrence Marina M Hoffman Nadia N Wedderburn Catherine J CJ Barnett Whitney W Zar Heather J HJ Stein Dan J DJ Halligan Sarah L SL

Developmental cognitive neuroscience 20230206

Maternal psychological distress during pregnancy has been linked to adverse outcomes in children with evidence of sex-specific effects on brain development. Here, we investigated whether in utero exposure to intimate partner violence (IPV), a particularly severe maternal stressor, is associated with brain structure in young infants from a South African birth cohort. Exposure to IPV during pregnancy was measured in 143 mothers at 28-32 weeks' gestation and infants underwent structural and diffusi ...[more]

PMID: 36764039

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Project description:Objectives Intimate partner violence (IPV) is an important contributor to the burden of disease in South Africa. Evidence-based approaches to IPV in primary care are lacking. This study evaluated a project that implemented a South African protocol for screening and managing IPV. This article reports primarily on the benefits of this intervention from the perspective of women IPV survivors. Design This was a project evaluation involving two urban and three rural primary care facilities. Over 4-8 weeks primary care providers screened adult women for a history of IPV within the previous 24 months and offered referral to the study nurse. The study nurse assessed and managed the women according to the protocol. Researchers interviewed the participants 1 month later to ascertain adherence to their care plan and their views on the intervention. Results In total, 168 women were assisted and 124 (73.8%) returned for follow-up. Emotional (139, 82.7%), physical (115, 68.5%), sexual (72, 42.9%) and financial abuse (72, 42.9%) was common and 114 (67.9%) were at high/severe risk of harm. Adherence to the management plan ranged from testing for syphilis 10/25 (40.0%) to consulting a psychiatric nurse 28/58 (48.3%) to obtaining a protection order 28/28 (100.0%). Over 75% perceived all aspects of their care as helpful, except for legal advice from a non-profit organisation. Women reported significant benefits to their mental health, reduced alcohol abuse, improved relationships, increased self-efficacy and reduced abusive behaviour. Two characteristics seemed particularly important: the style of interaction with the nurse and the comprehensive nature of the assessment. Conclusion Female IPV survivors in primary care experience benefit from an empathic, comprehensive approach to assessing and assisting with the clinical, mental, social and legal aspects. Primary care managers should find ways to integrate this into primary care services and evaluate it further.

Project description:Background: Intimate partner violence (IPV) continues to be a serious problem worldwide. South Africa has a high prevalence of women experiencing IPV. Although much research reports on the prevalence rates, risk factors, and consequences of IPV, fewer studies report on how women deal with the experiences of IPV. Objective: This systematic review of the empirical literature aimed to identify and synthesize the best available evidence on women's experiences of coping with IPV in South Africa. Methods: A four-level search and retrieval strategy using PRISMA and JBI guidelines was conducted, which included critical appraisal, study selection, data extraction, and data synthesis. Ten studies met the eligibility criteria and were included in the review. They were assessed to meet a set threshold (7/10) based on the JBI Critical Appraisal Checklist for Qualitative Research. All studies were conducted between 2010 and 2020, conducted in South Africa, and used qualitative methodologies to accomplish the overall aim of investigating IPV experiences of women and their responses to it. Results: The total number of women included in the studies was 159. The data extraction yielded 49 findings of which 47 were aggregated into 14 categories and three themes: (1) help- and support-seeking coping, (2) emotional regulation coping, and (3) problem avoidance and distraction coping. Help- and support-seeking coping refers to women's responses when they seek instrumental aid, advice, comfort, and/or understanding from others. Emotional regulation includes responses of women in which their emotions were expressed or regulated. Problem avoidance and distraction coping represent responses of women in which they take efforts to avoid thinking about the problem situation and rather reshift their focus. Conclusion: Overall, this review found that a variety of coping responses are used by South African women experiencing IPV. The findings point to the need for understanding IPV and responses to it within a broader social context rather than just at the personal level. Approaching IPV at many levels may lead to a change in societal norms, better access to and delivery of services to IPV survivors, more functional family affairs, and personal well-being and improved quality of life.

Dataset Information

Antenatal maternal intimate partner violence exposure is associated with sex-specific alterations in brain structure among young infants: Evidence from a South African birth cohort.

Publications

Antenatal maternal intimate partner violence exposure is associated with sex-specific alterations in brain structure among young infants: Evidence from a South African birth cohort.

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