Prenatal Exposure to Intimate Partner Violence and Child Developmental Outcomes: A Scoping Review Study

Background and Purpose: Pregnant women face an increased risk of intimate partner violence (IPV), compared to non-pregnant women. In addition to the risk of violence faced by women, there is a dual concern for risk of harm to the fetus. Expanding knowledge on childbirth outcomes, other domains of children’s development have been examined in recent literature. Yet, there is limited comprehensive knowledge in the area. This scoping review study, informed by ecobiodevelopmental theory, mapped evidence associating prenatal IPV exposure and children’s development.

Methods: Eligible studies through June 2022 were searched using PubMed, CINAHL, APA PsycArticles, APA PsycInfo, ISI Web of Science, Social Work Abstracts, Social Services Abstracts, ERIC, Google Scholar, and the references cited by retrieved studies. To be included in our review, the articles had to assess IPV exposure during the prenatal stage, and measure children’s development between birth to 17 years of age. Articles that were unavailable in English, not peer-reviewed, and/or focused only on birth outcomes were excluded. Two researchers independently assessed each article, and conflicting decisions were resolved by team discussion. After deduplication of the searches, 6,182 articles were identified for screening. Of those screened, 657 were assessed for eligibility. Of the full-text articles, 31 studies were eligible for our scoping review.

Results: Included studies were published between 2006 and 2022, with 39% published in the most recent five years, and 58% were conducted in the United States. Eighteen studies had sample sizes smaller than 500, and sample's race/ethnicity information was reported in 61% of the studies. Twenty-one studies were atheoretical, and six studies failed to consider covariates. Among six identified domains of child development in the literature, evidence on psychological (38%), behavioral (18%), physical health (18%), and physiological (13%) outcomes confirmed adverse effects of prenatal IPV exposure; with the inconsistency in results and a lack of empirical evidence, social (9%) and cognitive (5%) outcomes were identified as domains of need for further research. Existing research largely focused on infancy/toddlerhood (0-2 years; 55%) while much less is known about development in later stages. Seven mediators and eight moderators, mostly maternal behavioral health, were tested in 14 studies, significantly explaining the associations between prenatal IPV exposure and children’s development.

Conclusions and Implications: The review results provide an important glimpse into adverse associations between prenatal IPV exposure and children’s postnatal development, particularly psychological, behavioral, physical health, and physiological domains. Additional research on social and cognitive domains is needed to enhance understanding of the global and domain-specific effects of prenatal IPV exposure. Future studies should clarify ecobiodevelopmental mechanisms, including neurobiological and epigenetic pathways, explaining how prenatal IPV exposure influences long-term development. Prospective longitudinal studies, guided by theories of causal mechanisms and adjusting for empirically qualified confounders, will be critical to inform practice and policy to promote healthy development of prenatally IPV-exposed children. Rigorous reporting of the racial/ethnic characteristics of participants will enhance understanding of the intersectional nature of prenatal IPV experience and intergenerational implications. Incorporating strengths/asset-focused outcomes and examining sex/gender-specific effects may also advance the knowledge in this area.