Published online February 1, 2006
PEDIATRICS Vol. 117 No. 2 February 2006, pp. e278-e290 (doi:10.1542/10.1542/peds.2005-1473)

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Physical Health Outcomes of Childhood Exposure to Intimate Partner Violence: A Systematic Review

Megan H. Bair-Merritt, MD^a, Mercedes Blackstone, MD^b and Chris Feudtner, MD, PhD, MPH^a,c

^a Pediatric Generalist Research Group, Division of General Pediatrics
^b Division of Emergency Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
^c Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania

BACKGROUND. Children exposed to intimate partner violence (IPV) are at increased risk for adverse mental and behavioral health sequelae, as has been documented by both systematic reviews and meta-analyses. Studies addressing the physical health impact of childhood IPV exposure, however, have not been summarized in a manner that might facilitate additional hypothesis-driven research and accelerate the development of targeted interventions.

METHODS. To identify a comprehensive set of articles examining the association between childhood IPV exposure and physical health, we searched online bibliographic databases including Medline, CINAHL, PsychInfo, and Sociological Abstracts using the keywords "domestic" or "intimate partner violence" and "infant," "child," or "pediatric." From >2000 articles retrieved in the initial search, we used online abstract and bibliographic information to identify 94 articles potentially meeting the inclusion criteria of studies that (1) examined a postnatal physical health outcome related to IPV exposure and (2) had a contemporaneous control group. Thorough review of these 94 published studies yielded 22 that met these inclusion criteria. The data then were abstracted independently by 2 of the authors, and differences were settled with the assistance of a third author.

RESULTS. Childhood exposure to IPV increases the likelihood of risk-taking behaviors during adolescence and adulthood and is likely associated with underimmunization. Minimal data and study limitations preclude establishing a clear connection between IPV exposure and general health and use of health services, breastfeeding, or weight gain.

CONCLUSIONS. The impact on physical health from exposure to IPV during childhood is still uncertain. Future studies should be grounded in a theoretical model that specifies how IPV exposure can affect child health, should adjust for confounders adequately, should include a community-based sample, and should be of larger scale.

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Key Words: domestic violence • outcome • pediatric

Abbreviations: IPV—intimate partner violence • FTT—failure to thrive • DV—domestic violence • WIC—Supplemental Nutrition Program for Women, Infants, and Children • ACE—adverse childhood experience

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Accepted Aug 3, 2005.

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