Intimate partner violence during pregnancy and behavioral problems in children and adolescents: a meta-analysis

Elisabete P Silva, Andrea Lemos, Carlos H S Andrade, Ana B Ludermir

To evaluate the association of intimate partner violence during the gestational period and the development of externalizing and internalizing behavioral problems in children and adolescents. A meta-analysis of cohort and case-control studies was performed, using studies selected from electronic databases. Eligible studies included women who experienced intimate partner violence during pregnancy and their children's behavioral problems. These problems encompass two groups: externalizing problems (expressed by hyperactivity, aggressive and challenging behavior, and delinquency) and internalizing problems (represented by depressive moods, anxiety, and somatic symptoms). The risk of bias was assessed by the Newcastle-Ottawa Quality Assessment Scale (NOS) and the quality of evidence by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE). RevMan 5.3 software was used for the meta-analysis. Of the 687 eligible articles, only seven met all inclusion criteria and consisted of 12,250 mother/child pairs. The age range of the assessed children varied from 10 months to 16 years. The odds of internalizing problems in children exposed to prenatal violence were two-fold higher (OR=2.10, 95% CI: 1.17-3.76) and that of externalizing problems were 1.9-fold higher (95% CI: 1.28-2.83), when compared to children of unexposed mothers. The results of this study are consistent with the hypothesis that women's exposure to intimate partner violence during pregnancy may be associated with behavioral problems of their children, emphasizing the need for greater understanding about the vulnerability of children to adversity in early ages.