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A Prospective Cohort Study in Bangladesh

Kajsa Åsling-Monemi, MD; Ruchira Tabassum Naved, PhD; Lars Åke Persson, PhD

Arch Pediatr Adolesc Med. 2009;163(10):931-936.

Objective  To explore whether different forms of violence against women were associated with increased incidence rates of diarrhea and respiratory tract infections among infants.

Design  A 12-month follow-up study embedded in a food and micronutrient supplementation trial.

Setting  Rural Bangladesh.

Participants  Pregnant women and their 3132 live-born children.

Main Exposure  Maternal exposure to physical, sexual, and emotional violence and level of controlling behavior in the family.

Main Outcome Measures  Infants' risk of falling ill with diarrheal diseases and respiratory tract infections in relation to mothers' exposure to different forms of violence. Adjusted for household economic conditions, mother's education level, parity, and religion.

Results  Fifty percent of the women reported lifetime experience of family violence. Infants of mothers exposed to different forms of family violence had 26% to 37% higher incidence of diarrhea. Any lifetime family violence was positively associated with increased incidence of diarrheal diseases (adjusted rate ratio, 1.20; 95% confidence interval, 1.10-1.30) and lower respiratory tract infections (adjusted rate ratio, 1.31; 95% confidence interval, 1.17-1.46). Further, all forms of family violence were also independently positively associated with infant illness, and the highest incidence rates were found among the daughters of severely physically abused mothers.

Conclusion  Family violence against women was positively associated with an increased risk of falling ill with diarrheal and respiratory tract infections during infancy. The present findings add to increasing evidence of the magnitude of public health consequences of violence against women.

Authors Affiliations: International Maternal and Child Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden (Drs Åsling-Monemi and Persson); Public Health Sciences Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh (Dr Naved).

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