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

项目摘要/摘要 家庭暴力，包括亲密伴侣暴力(IPV)和虐待儿童，是一种重要的公共行为 健康问题，不成比例地影响到一岁以下的低收入和少数族裔妇女和儿童 年纪大了。围产期、怀孕期间和怀孕后几个月的家庭暴力与 许多代际健康差异，包括母亲的压力增加以及患上 婴儿心脏代谢健康和社会情绪发育不良。妊娠期传染性支气管炎病毒及其临床应用 与母亲压力的关联也可能使婴儿面临更大的虐待儿童的风险，并干扰 母婴共同调节生理和行为，进而对婴儿健康和发育产生负面影响。 此外，个体对不利环境的反应方式也不同，现有的模型表明 母亲和婴儿的复原力因素与家庭暴力相互作用，以增加对风险的脆弱性或促进 具有弹性的结果。然而，尚不清楚的是对压力调节和 将产前传染性支气管炎的特征与随后的虐待儿童和婴儿联系起来的人际机制 产后结局。因此，在这项纵向和前瞻性的研究中，我们建议研究一个 强调生物、行为和社会途径的机械论模型，以了解家庭的作用 围产期暴力在婴幼儿心脏代谢健康和社会情绪发育中的作用 句号。这项拟议的研究将收集自我报告、医疗记录、观察和生物行为数据 330个低收入、种族和民族多元化的家庭，跨越5个时间点：第一个(T1)、第二个(T2)和第三个(T3) 妊娠三个月、产后6个月(T4)和12个月(T5)。我们创新的二元方法来研究 将家庭暴力与围产期发育敏感期婴儿结局联系起来的机制将 解决三个目标。目标1是检查产前IPV的特征(时间、类型、频率、严重程度、 可预测性)与母亲的感知压力和生理压力有关。目标2是考察直接和间接的 产前IPV、母亲应激、儿童虐待风险、母婴生物行为的关系 共同调节，以及婴儿健康和发育。目标3是研究母亲和婴儿的韧性因素 缓和产前IPV、母亲压力、儿童虐待风险和母婴生物行为的影响 关于婴儿健康和发育的共同监管。我们的统一假设是产前传染性支气管炎的特征 母亲的压力会延续到产后阶段，对母婴关系产生负面影响 监管，但将在母婴的基础上与婴儿健康和发育有区别地联系 弹性因素。这项多方法研究将提供对家庭敏感时期的关键洞察 产前发生的暴力会对婴儿的结局产生持久的影响。确定可修改的机制 风险和复原力也将极大地为预防和干预战略提供信息，以减少 压力失调的代际传递，从而改善脆弱母亲和婴儿的生活。

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.