Naomi Abe, UCSF Benioff Children's Hospital San Francisco, San Francisco, CA, United States; Gretchen Bandoli, University of california san diego, San Diego, CA, United States
Associate Clinical Professor UCSF Benioff Children's Hospital San Francisco San Francisco, California, United States
Background: Intimate partner violence victimization (IPVV) in the parent is associated with adverse health outcomes in the child. The mechanism of risk conferment is poorly understood. It is also not clear what the optimal screening strategy or interventions are in the pediatric healthcare setting. Objective: In this study, we investigated the relation between maternal IPVV and infant healthcare utilization pattern in the infant’s first year of life. Design/Methods: We used the Future of Families and Child Wellbeing Study (FFCWS) data to study the relation between maternal report of IPVV and infant healthcare utilization in the first year of life. FFCWS data comes from a cohort of children born in large United States cities between 1998 and 2000. Births to unmarried mothers were oversampled by 3 to 1. We used the maternal report of IPVV in the prenatal period and in the first year postpartum, which consisted of physical, emotional, coercive or sexual IPVV. The outcomes (collected in the first year of life) were missed well child visits ( < 4 visits in first year of life), any sick clinic visits, any ED visits, frequent (≥ 4) ED visits, and any hospitalization. We used log-linear regression to compare relative risks of infant healthcare utilization pattern, adjusting for maternal age, race, education, payer source, marriage status, prenatal alcohol use, prenatal smoking, prenatal substance use. Results: Of the 4007 enrolled mothers, 1425 (35.6%) reported prenatal, 1831 (45.7%) reported postnatal IPVV, and 2,503 (62.4%) reported any IPVV. Mothers who reported IPVV were no more likely to assess their infant’s overall health as fair or poor compared to mothers who did not report IPVV, but their infants were at an increased risk of sick clinic visits for injury (adjusted relative risk [aRR] 1.3, 95% confidence interval [CI] 1.0, 1.6), any ED visits (aRR 1.1, 95% CI 1.0, 1.2), ED visits for injuries (aRR 1.2, 95% CI 1.0, 1.6), and frequent ED visits (aRR 1.4, 95% CI 1.1, 1.8). Estimates were similar when examined by prenatal IPVV or postnatal IPVV with the exception of missed well visits, which was only associated with postnatal IPVV (aRR 1.4, 95% CI 1.0, 1.8).
Conclusion(s): In this study, maternal IPVV was associated with increased acute care visits, especially for injuries, and frequent ED visits in the infant. Future studies should investigate the mechanism of association, as well as whether identification of such healthcare utilization pattern in the infant could help identify families that may benefit from IPVV screening, intervention, and resources allocation.
