Antenatal domestic violence, maternal mental health and subsequent child behaviour: a cohort study

OBJECTIVE: To investigate the long-term impact of antenatal domestic violence on maternal psychiatric morbidity and child behaviour. DESIGN: Cohort study. SETTING: Avon, UK. POPULATION OR SAMPLE: A birth cohort of 13,617 children and mother dyads were followed to 42 months of age. METHODS: Experiences of domestic violence and depressive symptoms were gathered at 18 weeks of gestation and up to 33 months after birth, together with maternal, paternal and child characteristics. MAIN OUTCOME MEASURES: Child behavioural problems were assessed at 42 months using the Revised Rutter Questionnaire. ANALYSIS: Logistic regression with the use of multiple imputation employing chained equations for missing data. RESULTS: Antenatal domestic violence was associated with high levels of maternal antenatal (odds ratio OR, 4.02; 95% confidence interval CI, 3.4-4.8) and postnatal (OR, 1.29; 95% CI, 1.02-1.63) depressive symptoms after adjustment for potential confounders. Antenatal domestic violence predicted future behavioural problems at 42 months in the child before adjustment for possible confounding and mediating factors (OR, 1.87; 95% CI, 1.45-2.40); this association was not significant after adjustment for high levels of maternal antenatal depressive symptoms, postnatal depressive symptoms or domestic violence since birth. CONCLUSIONS: Antenatal domestic violence is associated with high levels of both maternal antenatal and postnatal depressive symptoms. It is also associated with postnatal violence, and both are associated with future behavioural problems in the child at 42 months. This is partly mediated by maternal depressive symptoms in the ante- or postnatal period.