Prospective study of sexual, physical, and emotional violence and associated maternal and infant health risks among postpartum adolescents

Purpose: Among adolescent mothers during the postpartum period, few studies have examined the prevalence of intimate partner violence (IPV) by type (i.e., sexual, physical, and emotional), and the independent effect of each type on psychosocial maternal and infant health outcomes. Data: Sample of pregnant women aged 15-24 enrolled in a RCT of an HIV prevention intervention at two U.S. urban obstetrics and gynecology clinics in 2001-2004. Baseline interviews were completed during participants' second trimester (n=1,047). Follow-up surveys were collected 6 months (n=784) and 12 months postpartum (n=840). Methods: Logistic and linear regression models assessed the association between each IPV type (i.e., sexual, physical, and emotional) and maternal and infant health outcomes adjusting for socio-demographic effects. Results: Overall prevalence of physical or sexual violence was 15% and emotional violence 30% postpartum. The relative risk of revictimization 6 months after an event ranged from 2.9-3.5 across IPV types. For mothers, physical and emotional violence at 6 months was associated with less post-traumatic growth and increased stress and depression at 12 months. Sexual violence at 6 months increased odds of clinical STI diagnosis at 12 months. All IPV types at 6 months were associated with increased infant dysfunction, sleep dysregulation, and attention problems at 12 months. Conclusions: Adolescent mothers remain at risk of IPV after pregnancy. IPV experienced postpartum is associated with adverse psychosocial and behavioral maternal and infant health outcomes. Screening for IPV, including emotional violence, among young mothers may prevent long-term ill-health effects for both mother and child.