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

家庭暴力与围产期婴儿健康和发育的联系机制

• 批准号: 10795256
• 负责人: Samantha M Brown
• 金额: $ 68.37万
• 依托单位: COLORADO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-19 至 2028-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10795256
• 关键词: 1 year old; Affect; Attenuated; Autonomic nervous system; Behavior; Behavioral; Biological; Characteristics; Child Abuse and Neglect; Child Health; Data; Development; Emotional; Environment; Exposure to; Family; Family Violence; Fetal Development; First Pregnancy Trimester; Frequencies; Functional disorder; Generations; Health; Heart Rate; Hydrocortisone; Hypothalamic structure; Individual; Individual Differences; Infant; Infant Development; Infant Health; Intervention; Life; Link; Longitudinal Studies; Low income; Maternal Health; Mediating; Medical Records; Metabolic; Methods; Minority; Minority Women; Mission; Modeling; Mothers; National Institute of Child Health and Human Development; Outcome; Pathway interactions; Patient Self-Report; Pattern; Perinatal; Personal Satisfaction; Physiological; Physiology; Pituitary-Adrenal System; Postpartum Period; Pregnancy; Prevention strategy; Process; Prospective Studies; Public Health; Regulation; Research; Risk; Role; Second Pregnancy Trimester; Severities; Social support; Stress; Stress and Coping; System; Third Pregnancy Trimester; Time; Woman; Work; biobehavior; cardiometabolism; cohort; ethnic diversity; health disparity; high risk; improved; infant outcome; innovation; insight; intergenerational; intimate partner violence; intrauterine environment; maltreatment; maternal outcome; maternal stress; minority children; negative affect; perceived stress; perinatal development; perinatal period; post pregnancy; postnatal period; postpartum outcome; prenatal; promote resilience; prospective; racial diversity; resilience; resilience factor; response; social; stem; transmission process; violence exposure

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.

项目总结/摘要 家庭暴力包括亲密伴侣暴力和虐待儿童行为，是社会上的一个重大公共问题， 低收入和少数群体妇女和一岁以下儿童受到不成比例的影响 年龄。围产期、怀孕期间和怀孕后几个月的家庭暴力与下列因素有关： 代际间的许多健康差异，包括母亲的压力增加以及 婴儿的心脏代谢健康和社会情感发育不良。怀孕期间的IPV及其 与母亲压力的联系也可能使婴儿遭受虐待的风险更大， 母婴共同调节生理和行为，反过来又对婴儿的健康和发育产生负面影响。 此外，个体对不利环境的反应不同，现有模型表明， 产妇和婴儿的复原力因素与家庭暴力相互作用，使其易受风险的影响，或促进 弹性成果。然而，仍然未知的是对压力调节的深入理解， 将产前IPV特征与随后的儿童虐待和婴儿 产后结果因此，在这项纵向和前瞻性研究中，我们建议检查一个 强调生物学、行为学和社会学途径以理解家庭作用的机械模型 围产期婴儿心脏代谢健康和社会情感发展过程中的暴力 期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、种族和民族多样化的家庭，5个时间点：第1（T1）、第2（T2）和第3（T3） 妊娠期和产后6个月（T4）和12个月（T5）。我们创新的二元方法来研究 在围产期发育的敏感时期，将家庭暴力与婴儿结局联系起来的机制将 实现三个目标。目的1是检查产前IPV的特征（时间、类型、频率、严重程度， 可预测性）与母亲感知的和生理的压力有关。目的2是检查直接和间接 产前IPV、母亲压力、儿童虐待风险、母婴生物行为 协同调节和婴儿健康与发育。目的3是研究母亲和婴儿的弹性因素 减轻产前IPV、母亲压力、儿童虐待风险和母婴生物行为的影响 对婴儿健康和发育的共同监管。我们的统一假设是产前IPV的特征 母亲的压力会延续到产后，对母婴关系产生负面影响， 监管，但将差异与婴儿的健康和发展的基础上，孕产妇和婴儿 弹性因素。这项多方法研究将提供关键的洞察敏感时期， 产前发生的暴力行为对婴儿的结局有着持久的影响。确定可修改的机制 风险和复原力也将为预防和干预战略提供重要信息， 这将有助于消除压力失调的代际传递，从而改善弱势母亲和婴儿的生活。