Association of Exposure to Intimate Partner Violence With Maternal Depressive Symptoms and Early Childhood Socioemotional Development Among Mothers and Children in Rural Tanzania

Abstract

ImportanceApproximately 1 in 4 women experience intimate partner violence (IPV) or nonpartner sexual violence during their lifetime. Mothers exposed to IPV are more likely to experience depressive symptoms and to discipline their children harshly, which may affect their children’s socioemotional development; however, there is limited evidence on these outcomes.ObjectiveTo examine the association between IPV, maternal depressive symptoms, harsh child discipline, and child stimulation with child socioemotional development.Design, Setting, and ParticipantsThis study used cross-sectional follow-up data collected from February 19 to October 10, 2014, from a birth cohort of children aged 18 to 36 months who were enrolled in a randomized, double-blind, placebo-controlled trial of neonatal vitamin A supplementation in the Morogoro region of Tanzania. Data analysis occurred between September 10, 2019, and January 20, 2020.ExposuresLifetime experience of IPV was assessed using an abbreviated module of the Tanzania Demographic and Health Survey, maternal depressive symptoms were assessed with the Patient Health Questionnaire, and data on harsh child discipline and maternal stimulation of their children were collected using modules of the United Nations Children's Fund Multiple Indicator Cluster Survey.Main Outcomes and MeasuresChild socioemotional development was measured by the Caregiver-Reported Early Childhood Development Instruments.ResultsA total of 981 mother-child dyads were included in the analytic sample; 388 children (39.6%) were between ages 18 and 24 (mean [SD] age, 27.06 [6.08]) months, and 515 (52.5%) were male children. A negative association was observed between maternal report of physical IPV only (mean difference, −0.022; 95% CI, −0.045 to −0.006) and physical and sexual IPV (mean difference, −0.045; 95% CI, −0.077 to −0.013) with child socioemotional scores, but neither was statistically significant after including depressive symptoms in the model, which is consistent with mediation. Furthermore, a negative association was observed between maternal mild to severe depressive symptoms and child socioemotional development, including adjustment for IPV (mean difference, −0.073; 95% CI, −0.103 to −0.043). Harsh disciplinary practices and stimulation were not associated with child socioemotional development after adjusting for IPV, maternal depressive symptoms, and other factors.Conclusions and RelevanceThe findings of this study suggest that maternal depressive symptoms may explain the negative association between IPV and child socioemotional development.

Neurodevelopment of children who are HIV‐exposed and uninfected in Kenya

“…Maternal marital status, absence of a biologic father, IPV and food insecurity were significantly associated with lower child neurodevelopment scores. Parental relationship conflict and household violence can threaten a child's neurodevelopment [ 22 , 45 , 46 , 47 , 48 , 49 , 50 , 51 ]. Over a quarter of women of reproductive age in eastern Africa were estimated to have experienced IPV in the past year [ 26 , 52 , 53 ]; the prevalence of IPV among Kenyan pregnant women is estimated to be approximately 10%, with almost all perpetrators being a current or former husband or partner [ 54 ].…”

Father involvement is a protective factor for maternal mental health in Western Kenya

“…Our findings revealed that the protective associations of father involvement may be especially beneficial for maternal mental health during the earliest month of parenthood ( Wang et al, 2021 ), and thus suggesting a potentially promising window for interventions. Additionally, given that maternal depression has been linked to parenting and child development ( Ramos de Oliveira et al, 2022 ), fathers’ support for maternal mental health should be explored as an avenue for improving child development outcomes.…”

‘When there is love between a father and mother, the child will also be loved’: a qualitative exploration of the links between couples’ relationships, parenting and early childhood development in Mwanza, Tanzania

“…Supporting the parental mental health mechanism, prior quantitative studies have demonstrated the potential mediating role of maternal stress, depression and post-traumatic stress disorder symptoms in the relationship between IPV and child outcomes. [37][38][39] Similarly, in a qualitative study in Timor-Leste, mothers commonly described how their experiences of IPV led to episodes of explosive anger, which was often accompanied by harsh parenting. 27 Regarding the role of parent-child bonding, a qualitative evaluation of a BMJ Public Health violence-prevention intervention in Uganda found that participating couples who reported reductions in IPV also expressed improvements in parenting and discipline practices, which contributed to stronger parent-child relationships.…”