Prenatal and Early Intimate Partner Psychological Violence and Children's Hospital Health Care Use: The ELFE Cohort.

OBJECTIVE

To determine the association between parental psychological intimate partner violence (IPV) before and around the time of the child's birth, and their use of an emergency department (ED) and hospitalization from 2 months to 10 years of age.

METHODS

In the population-based French birth cohort Etude Longitudinale Française depuis l'Enfance, which included children born in 2011, parents reported Psychological-IPV before and during pregnancy, as well as during the first 2 months after childbirth. They reported on 1) child ED visits that did not result in hospitalization, and 2) hospitalizations that followed an ED visit or were scheduled between ages 2 months and 10 years. Group-based trajectory modeling was used to identify trajectories of psychological-IPV. The association between parental psychological-IPV and children's hospital health care use was tested using weighted multivariate regression models.

RESULTS

Four psychological-IPV trajectories were identified: minimal (71%), decreasing (11%), persistent (9%), and increasing (9%). Comparative analyses involved 8475 children for ED visits, and 8540 for hospitalizations. Decreasing (incidence rate ratio [IRR] 1.4, (95% confidence interval [CI] 1.12, 1.61)) and persistent psychological-IPV trajectories (IRR 1.4, (95%CI 1.16, 1.57)) were significantly associated with children's higher number of ED visits without hospitalization, compared to a minimal trajectory of IPV. When parents experienced a decreasing IPV trajectory, these visits were more often due to poisoning, fever, or respiratory problems. No statistically significant difference was observed for the number of hospitalizations.

CONCLUSIONS

Our study highlights associations between decreasing and early persistent parental psychological-IPV and children's ED use. Supporting parents to prevent psychological-IPV could improve children's future health.