Mechanisms Linking Family Violence and Infant Health and Development in the Perinatal Period

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PROJECT SUMMARY/ ABSTRACT Family violence, which includes intimate partner violence (IPV) and child maltreatment, is a significant public health problem and disproportionately affects low-income and minoritized women and children under one year of age. Family violence during the perinatal period, the months during and after pregnancy, has been linked to numerous health disparities intergenerationally, including elevated stress in mothers as well as increased risk of poor cardiometabolic health and socioemotional development in infants. IPV during pregnancy and its associations with maternal stress may also place infants at greater risk of child maltreatment and interfere with mother-infant coregulation of physiology and behavior, in turn negatively affecting infant health and development. Moreover, individuals differ in how they respond to adverse environments, with extant models suggesting that maternal and infant resilience factors interact with family violence to confer vulnerability to risk or to promote resilient outcomes. What remains unknown, however, is an advanced understanding of the stress regulation and interpersonal mechanisms that link characteristics of prenatal IPV to subsequent child maltreatment and infant outcomes postpartum. Therefore, in this longitudinal and prospective study, we propose to examine a mechanistic model highlighting biological, behavioral, and social pathways to understand the role of family violence in the progression of infant cardiometabolic health and socioemotional development during the perinatal period. The proposed study will collect self-report, medical record, observational, and biobehavioral data from 330 low-income, racially and ethnically diverse families across 5 time points: 1st (T1), 2nd (T2), and 3rd (T3) trimesters and 6 (T4) and 12 months (T5) postpartum. Our innovative dyadic approach to studying the mechanisms linking family violence to infant outcomes during the sensitive period of perinatal development will address three aims. Aim 1 is to examine how characteristics of prenatal IPV (timing, type, frequency, severity, predictability) relate to maternal perceived and physiologic stress. Aim 2 is to examine the direct and indirect associations among prenatal IPV, maternal stress, child maltreatment risk, mother-infant biobehavioral coregulation, and infant health and development. Aim 3 is to examine how mother and infant resilience factors moderate the impacts of prenatal IPV, maternal stress, child maltreatment risk, and mother-infant biobehavioral coregulation on infant health and development. Our unifying hypothesis is that characteristics of prenatal IPV and maternal stress will carry over into the postnatal period to negatively affect mother-infant relations and regulation but will be differentially associated with infant health and development based on maternal and infant resilience factors. This multi-method study will provide critical insight into sensitive periods whereby family violence that occurs prenatally has a lasting impact on infant outcomes. Identifying modifiable mechanisms of risk and resilience will also greatly inform strategies for prevention and intervention to lessen the intergenerational transmission of stress dysregulation, thus improving the lives of vulnerable mothers and infants.