Short summary

We find ourselves in a world where a third of all women have experienced intimate partner violence, and where depression is the leading cause of functional disability. We are following up on a Tanzanian cohort of women, who were pregnant in 2014-2015, and their children. The objective is to determine how the mothers' exposure to violence or depression during pregnancy influences breastfeeding practices and the growth of the children later in life. 

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Rationale

We find ourselves in a world where a third of all women have experienced intimate partner violence, and where depression is the leading cause of functional disability. Despite these overwhelming numbers, intimate partner violence has only just been added to the UN's agenda in 2015 with the new Sustainable Development Goals, and depression and mental health continue to be neglected.

In 2014 the PAVE study followed more than 1100 Tanzanian women through their pregnancies, establishing that intimate partner violence during pregnancy has a detrimental influence on premature birth and low birth weight, and also increases the mother's risk of developing postpartum depression.

There is a substantial lack of knowledge about what happens to the children of these mothers as they grown up. We will therefore return to Tanzania and follow up on the PAVE study, this time focusing on the growth of the children of mothers that have been exposed to intimate partner violence and/or depression in connection to their pregnancies, compared to those of mothers that have not experienced these exposures.

Increasing our knowledge about the consequences of these exposures will help enable the creation and implementation of interventions to stop intimate partner violence and help women suffering from perinatal depression. This in turn will improve reproductive health, in accordance with the UN's development goals.

This project will be executed as two concurrent undergraduate research years, in collaboration with the research division of the Gynecological and Obstetric Department at Odense University Hospital, OUH, and the Kilimanjaro Christian Medical Centre, KCMC. The project is supported by the DANIDA Fellowship Centre.

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Description of the cohort

The cohort was established by the PAVE project in Moshi, Tanzania in 2014. Pregnant women who went for antenatal care at two local clinics were enrolled and followed throughout their pregnancies until approximately 40 days postpartum.

More than 1100 women were enrolled. Women who were found to have multiple pregnancies, or who had miscarriages or abortions, were excluded. The follow-up rate from enrollment to the final interview in the PAVE study was 99%. Based on this exceptional follow-up rate, and the fact that very detailed contact information was gathered for the participating women, we expect to be able to include at least 80% (n=890) of the mothers of the original cohort, and the children they gave birth to during the study.

Data and biological material

The data will be collected through a questionnaire and clinical measurements. The questionnaire will focus on obtaining information on breast feeding history as well as current data on depression and intimate partner violence exposure. It will also update our sociodemographic information, record the vaccination status of the children and the HIV status of mothers and children.

The clinical measurements are the main outcome and consist of the height and weight of the children, as measured in conjunction with the interview. The height and weight of the mothers will also be recorded.

Collaborating researchers and departments

Faculty of Health Sciences, University of Southern Denmark

• Pre-graduate research student Frederikke Kjerulff Madsen
• Pre-graduate research student Christina Elise Holm-Larsen

Research Division of Gynecology and Obstetrics, Department of Clinical Research, University of Southern Denmark

• Professor Vibeke Rasch, DMSc, PhD

Department of Family Health, KCMC.

• External lecturer Geofrey Nimrody Sigalla