B502 - The impact of domestic violence during pregnancy on child development - 30/05/2007
Background: Domestic violence may start or increase in severity during pregnancy (Gazmararian et al 1996; Bowen et al, 2005). The main health effect specific to domestic violence during pregnancy is the threat to health and risk of death of the mother, foetus, or both, from trauma (El Kady et al, 2005; Pearlman et al, 1990). Domestic violence is also associated with depression, anxiety, insomnia, alcohol and drug abuse, and suicide attempts (Campbell 2002). However, the impact of domestic violence during pregnancy on the risk ofchild development has not been previously investigated to our knowledge. A recent study has reported, though, on the significant impact of postnatal domestic violence on child development, which, with postnatal depression, had a cumulative effect, leading to worse child outcome (Whitaker et al, 2006). There is increasing evidence that prenatal stress and major depression during pregnancy are associated with increased concentrations of corticotrophin releasing hormone (O'Keane et al, submitted); this increase in pituitary-adrenal activity may explain the association of domestic violence during pregnancy with poor obstetric outcomes (low birthweight and preterm pregnancy) . Domestic violence may therefore adversely affect child development independent of the effect of antenatal psychiatric morbidity or subsequent psychiatric morbidity, but any effects on child development may also be partly mediated by antenatal psychiatric morbidity.