Association between perinatal intimate partner violence and breastfeeding outcomes: a systematic review and meta-analysis.
8 affiliations
- 1School of Medical, Indigenous and Health Sciences, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong, NSW, 2522, Australia. [email protected].
- 2Department of Women's and Family Health, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia. [email protected].
- 3School of Population Health, Curtin University, Perth, WA, Australia.
- 4The Florey Institute of Neuroscience and Mental Health, University of Melbourne, 30 Royal Parade, Parkville, VIC, 3052, Australia.
- 5Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia.
- 6Graduate School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia.
- 7Discipline of Psychiatry and Mental Health, School of Clinical Medicine, UNSW Sydney and St John of God Burwood Hospital, Sydney, Australia.
- 8School of Medical, Indigenous and Health Sciences, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong, NSW, 2522, Australia.
Abstract
Background
Intimate partner violence (IPV) negatively affects the health of both the mother and the child. These risks are particularly critical during the perinatal period, a time of heightened vulnerability. However, the relationship between maternal IPV exposure and breastfeeding outcomes remains uncertain, and existing findings are inconsistent and inconclusive. Therefore, this systematic review and meta-analysis aimed to synthesise the existing evidence on the association between perinatal IPV and breastfeeding outcomes.Methods
A systematic literature search was conducted using relevant databases between June 15 and August 2, 2024. All peer-reviewed observational studies that specifically investigated the link between Perinatal (P)-IPV and breastfeeding outcomes, such as early initiation, exclusivity, and duration among the perinatal population, were included. Heterogeneity across the included studies was assessed using the Cochrane Q test and I² statistics. Publication bias was assessed through funnel plots and Egger's test. Finally, a random effects model was used to estimate the pooled adjusted odds ratios and their 95% CIs.Results
Nineteen observational studies published between 2007 and 2024, comprising 347,706 mother-child pairs, were included in the review. Of these, 17 studies were eligible for the meta-analysis. A meta-analysis of nine studies indicated that P-IPV was associated with a 36% higher odds of delayed initiation of breastfeeding (AOR: 1.36; 95% CI: 1.14-1.63), with both physical (AOR: 1.20; 95% CI: 1.02-1.42) and psychological P-IPV (AOR: 1.38; 95% CI: 1.09-1.74) were associated with higher odds of not initiating breastfeeding within one hour of birth. Similarly, women exposed to P-IPV had higher odds of not exclusively breastfeeding (EBF) at six months (AOR: 1.50; 95% CI: 1.21-1.85), with similar associations observed for both physical (AOR: 1.52; 95% CI: 1.18-1.95) and psychological P-IPV (AOR: 1.56; 95% CI: 1.39-1.76).Conclusions
This review found that P-IPV was associated with delayed breastfeeding initiation and a lower likelihood of EBF at six months. The findings highlight the potential value of trauma-informed and trauma-sensitive screening, support, and referral pathways for women experiencing P-IPV.
Related
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BibTeX
@article{azene2026association,
title = {{Association between perinatal intimate partner violence and breastfeeding outcomes: a systematic review and meta-analysis.}},
author = {Zelalem Nigussie Azene and Berihun Dachew and Mehari Woldemariam Merid and Nicole Reilly and Catherine MacPhail},
journal = {BMC pregnancy and childbirth},
year = {2026},
month = jul,
doi = {10.1186/s12884-026-09737-3},
url = {https://europepmc.org/article/MED/42907962},
note = {CC BY},
}
RIS
TY - JOUR
TI - Association between perinatal intimate partner violence and breastfeeding outcomes: a systematic review and meta-analysis.
AU - Zelalem Nigussie Azene
AU - Berihun Dachew
AU - Mehari Woldemariam Merid
AU - Nicole Reilly
AU - Catherine MacPhail
PY - 2026
DA - 2026/07/01
JO - BMC pregnancy and childbirth
DO - 10.1186/s12884-026-09737-3
UR - https://europepmc.org/article/MED/42907962
AB - Background Intimate partner violence (IPV) negatively affects the health of both the mother and the child. These risks are particularly critical during the perinatal period, a time of heightened vulnerability. However, the relationship between maternal IPV exposure and breastfeeding outcomes remains uncertain, and existing findings are inconsistent and inconclusive. Therefore, this systematic review and meta-analysis aimed to synthesise the existing evidence on the association between perinatal IPV and breastfeeding outcomes.Methods A systematic literature search was conducted using relevant databases between June 15 and August 2, 2024. All peer-reviewed observational studies that specifically investigated the link between Perinatal (P)-IPV and breastfeeding outcomes, such as early initiation, exclusivity, and duration among the perinatal population, were included. Heterogeneity across the included studies was assessed using the Cochrane Q test and I² statistics. Publication bias was assessed through funnel plots and Egger's test. Finally, a random effects model was used to estimate the pooled adjusted odds ratios and their 95% CIs.Results Nineteen observational studies published between 2007 and 2024, comprising 347,706 mother-child pairs, were included in the review. Of these, 17 studies were eligible for the meta-analysis. A meta-analysis of nine studies indicated that P-IPV was associated with a 36% higher odds of delayed initiation of breastfeeding (AOR: 1.36; 95% CI: 1.14-1.63), with both physical (AOR: 1.20; 95% CI: 1.02-1.42) and psychological P-IPV (AOR: 1.38; 95% CI: 1.09-1.74) were associated with higher odds of not initiating breastfeeding within one hour of birth. Similarly, women exposed to P-IPV had higher odds of not exclusively breastfeeding (EBF) at six months (AOR: 1.50; 95% CI: 1.21-1.85), with similar associations observed for both physical (AOR: 1.52; 95% CI: 1.18-1.95) and psychological P-IPV (AOR: 1.56; 95% CI: 1.39-1.76).Conclusions This review found that P-IPV was associated with delayed breastfeeding initiation and a lower likelihood of EBF at six months. The findings highlight the potential value of trauma-informed and trauma-sensitive screening, support, and referral pathways for women experiencing P-IPV.
SN - 1471-2393
ER -