Intimate Partner Violence during Pregnancy and Early Offspring Development:A Prospective Birth Cohort Study

孕期亲密伴侣暴力与早期后代发育:一项前瞻性出生队列研究

Authors：Nan Jiang, Shuang-Shuang Ma, Ping Zu, Lei Zhang, Min Xu, Jing-Feng Bian, Ji-Rong Xu, Wei Luo, Hai-Xia Wang, Dao-Min Zhu, Peng Zhu
Source：Biological Psychiatry
DOI: 10.1016/j.biopsych.2025.03.020 

Abstract

Background: Intimate partner violence (IPV) during pregnancy is linked to several unfavorable outcomes for both mothers and babies. However, few studies have examined its connections to early infant neurodevelopment, and the underlying processes of these connections remain unclear.

Methods: Our research conducted within a prospective birth cohort from March 2018 to July 2023 of 3007 mother-child pairs. Participants were followed from pregnancy until the offspring were 12 months old. We collected data on IPV during pregnancy, prenatal depression, postpartum depression, umbilical cord blood inflammatory index, and Third Edition of the Ages and Stages Questionnaire (ASQ-3), and used multiple logistic regression analysis to examine the relationship between IPV during pregnancy and children's neurodevelopmental delay.

Results: In our study cohort, 9.8% of pregnant women experienced IPV during pregnancy, and 8.7% experienced psychological violence. Psychological violence was associated with increased relative risks (RRs) of failure in the communication, problem-solving, and personal-social domains of the ASQ-3. The corresponding 95% confidence intervals (CIs) were 1.95 (1.24, 3.07), 2.10 (1.25, 3.52), and 1.97 (1.29, 3.02), respectively. Moreover, IPV during pregnancy combined with depression further exacerbated these risks. Additionally, 19.6% of the association between IPV during pregnancy and prenatal depression was mediated by cord blood inflammatory indices in relation to ASQ-3 failure risk.

Conclusions: This prospective birth cohort study indicates that the significant negative impact of psychological violence on offspring's neurodevelopmental delay depends on the intensity of psychological stress, with umbilical cord blood inflammation being a potential underlying biological mechanism.

Keywords: Infant health; Inflammation; Intimate partner violence; Neurodevelopment; Prenatal depression; Psychological stress.

摘要

背景：孕期亲密伴侣暴力（IPV）与母婴不良结局密切相关。然而，很少有研究探讨其与婴儿早期神经发育的联系，且这些联系背后的机制尚不清楚。

方法：本研究于2018年3月至2023年7月在一项前瞻性出生队列研究中进行，共纳入3007对母婴。研究对象从孕期开始随访，直至其子女12个月大。我们收集了孕期IPV、孕期抑郁、产后抑郁、脐带血炎症水平以及《年龄与阶段问卷》第三版（ASQ-3）的数据，并采用多变量逻辑回归分析来研究孕期IPV与儿童神经发育迟缓之间的关系。

结果：在本研究队列中，9.8%的孕妇在孕期经历了IPV，其中8.7%经历了精神暴力。精神暴力暴力与ASQ-3中沟通、解决问题和个人社交领域的失败风险增加相关，相对风险（RR）和95%置信区间（CI）分别为1.95（1.24, 3.07）、2.10（1.25, 3.52）和1.97（1.29, 3.02）。此外，孕期精神暴力与产前抑郁共存进一步加剧了这些风险。中介分析表明，产前抑郁和脐血炎症水平可能在孕期IPV与子代神经发育迟缓的关联中起到中介作用[间接效应，0.11（95% CI：0.04，0.18），间接效应占总效应的19.6%。

结论：本前瞻性出生队列研究表明，精神暴力对后代神经发育迟缓的显著负面影响取决于心理应激的强度，脐带血炎症可能是潜在的生物学机制。

关键词：亲密伴侣暴力；炎症；孕期抑郁；心理应激；婴儿健康；神经发育