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most of the studies show the physical consequences&#44; including low birth weight&#44; prematurity&#44; miscarriage&#44; and neonatal and perinatal mortality&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">1</span></a> Reviews published to date on IPV exposure during pregnancy<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">4&#44;9</span></a> have shown physical consequences&#44; but have not reported the association with behavioral problems of children and adolescents&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">While there is a growing body of research on children&#39;s exposure to IPV suffered by their mothers&#44;<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">10&#8211;12</span></a> little is known about the long-term consequences of prenatal exposure to violence regarding the child&#39;s mental development&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Studies have been conducted to understand how IPV&#44; a proven stressful event during pregnancy&#44; hinders the development of children&#39;s emotional and behavioral regulation systems&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">13</span></a> Prenatal stress has been shown to be mediated by maternal and fetal cortisol levels&#44; which alter the programming of fetal neurons&#44;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">14</span></a> and may play an important role in the child&#39;s social and emotional development&#46;<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">15&#44;16</span></a> There is evidence that exposure to IPV may predispose to externalizing problems that include antisocial behavior&#44; conduct and impulse control disorders&#44; which can be expressed by hyperactivity&#44; aggressive and defiant behavior&#44; and delinquency&#46;<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">17&#8211;20</span></a> The internalizing symptomatology is represented by depression&#44; anxiety&#44; introspection&#44; and somatic symptoms&#46;<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">17&#8211;19</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">The objective of this review was to assess whether IPV during pregnancy is associated to the development of behavioral problems of children and adolescents in the long term&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Methods</span><p id="par0025" class="elsevierStylePara elsevierViewall">The description of this review followed the parameters of the Meta-analysis of Observational Studies in Epidemiology &#40;MOOSE&#41;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">21</span></a> and the Preferred Reporting Items for Systematic Reviews and Meta-analysis &#40;PRISMA&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">22</span></a> recommended by the international literature for the reporting systematic reviews of observational studies&#46; The previously established protocol was registered in an international database of systematic review protocols&#58; International Prospective Register of Systematic Reviews &#40;PROSPERO&#41; under No&#58; CRD42015026382&#44; accessible by the link&#58; <a id="intr0015" class="elsevierStyleInterRef" href="https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=26382">https&#58;&#47;&#47;www&#46;crd&#46;york&#46;ac&#46;uk&#47;prospero&#47;display&#95;record&#46;php&#63;RecordID&#61;26382</a>&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Eligibility criteria</span><p id="par0030" class="elsevierStylePara elsevierViewall">The studies were eligible if they met the criteria&#58; &#40;a&#41; type of study&#58; cohort or case&#8211;control studies&#59; &#40;b&#41; population&#58; pregnant women in any trimester of pregnancy&#44; regardless of age group &#40;c&#41; exposure&#58; clear definition &#40;given by the authors&#41; of physical&#44; sexual&#44; or psychological violence perpetrated by the intimate partner during pregnancy&#59; &#40;d&#41; outcome&#58; behavioral&#44; externalizing&#44; and&#47;or internalizing problems in children and adolescents&#44; evaluated with validated tools&#46; Studies that assessed violence against women perpetrated by men other than their intimate partners&#44; and studies that assessed the child&#39;s direct exposure to violence were excluded&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Sources of information</span><p id="par0035" class="elsevierStylePara elsevierViewall">The search strategy included references&#44; until June 2017&#44; from the following electronic databases&#58; MEDLINE&#47;PubMed &#40;1966&#8211;2017&#41;&#44; LILACS &#40;1982&#8211;2017&#41;&#44; CINAHL &#40;1981&#8211;2017&#41;&#44; Web of Science &#40;1945&#8211;2017&#41;&#44; Scopus &#40;1950&#8211;2017&#41;&#44; and PsycINFO &#40;1887&#8211;2017&#41;&#46; The Medical Subject Headings &#40;MeSH&#41; terms and entries were used for MEDLINE&#47;PubMed&#44; Web of Science and Scopus&#59; the Descriptors in Health Sciences &#40;DeCS&#41; for LILACS&#59; the CINAHL titles for CINAHL and the Thesaurus of Psychological Index Terms for PsycINFO&#46; The search included the terms&#58; &#8220;domestic violence&#8221; OR &#8220;family violence&#8221; OR &#8220;spouse violence&#8221; OR &#8220;spouse abuse&#8221; OR &#8220;partner violence&#8221; OR &#8220;intimate partner violence&#8221; OR &#8220;intimate partner abuse&#8221; OR &#8220;violence against women&#8221; OR &#8220;partner abuse&#8221; OR &#8220;verbal abuse&#8221; OR &#8220;psychological abuse&#8221; OR &#8220;physical abuse&#8221; OR &#8220;sexual abuse&#8221; OR &#8220;antenatal domestic violence&#8221; AND &#8220;prenatal&#8221; OR &#8220;antenatal&#8221; OR &#8220;pregnant women&#8221; OR &#8220;pregnancy&#8221; OR &#8220;pregnant&#8221; AND &#8220;child&#42; behavior disorders&#8221; OR &#8220;child&#42; behavior problems&#8221; OR &#8220;child behavior&#8221; OR &#8220;child development&#8221; OR &#8220;child development disorders&#8221; OR &#8220;maltreatment&#8221; OR &#8220;behavior disorders&#8221; OR &#8220;behavior problems&#8221; OR &#8220;conduct disorder&#8221;&#46; A specific search strategy was used for each database&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Study selection and data extraction</span><p id="par0040" class="elsevierStylePara elsevierViewall">In the first phase&#44; the study selection was carried out by two researchers &#40;E&#46;P&#46;S&#46; and C&#46;H&#46;S&#46;A&#46;&#41;&#44; who independently evaluated the titles and abstracts of the articles retrieved by the search strategy&#44; with no language or date restriction&#46; At this phase&#44; articles inclusion was carried out according to the established eligibility criteria&#46; Articles that raised questions and were potentially eligible were retained for subsequent full-text review&#46; At the second phase&#44; the full-text articles were evaluated&#46; The reference lists of the included articles were also evaluated to verify whether any potentially eligible article was not present in the initial search carried out in the databases&#46; Articles were excluded when they did not meet the eligibility criteria&#46; At the third phase&#44; the data were extracted according to a previously established form&#46; Disagreements were resolved by consensus and by consultation and supervision of a third researcher &#40;A&#46;B&#46;L&#46;&#41;&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Risk of bias assessment of articles</span><p id="par0045" class="elsevierStylePara elsevierViewall">The risk of bias of the included studies was independently analyzed by two reviewers &#40;E&#46;P&#46;S&#46; and C&#46;H&#46;S&#46;A&#46;&#41; using the Newcastle-Ottawa Quality Assessment Scale &#40;NOS&#41;&#44; which evaluates the design and quality of cohort and case&#8211;control studies&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">23</span></a> This scale facilitates the incorporation of quality assessments in the interpretation of meta-analysis results and is not used as an inclusion or exclusion criterion for articles&#46; It consists of eight items&#44; divided into three dimensions&#58; selection&#44; comparability&#44; and outcome &#40;for cohort studies&#41; or exposure &#40;for case&#8211;control studies&#41;&#46; Each article is assigned a number of stars&#58; &#40;a&#41; selection &#40;maximum&#58; four stars&#41;&#59; &#40;b&#41; comparability &#40;maximum&#58; two stars&#41;&#59; and &#40;c&#41; results &#40;maximum&#58; three stars&#41;&#46; Therefore&#44; during the processing of the article quality analysis&#44; high-quality studies can achieve a maximum of nine stars&#46; However&#44; the final evaluation should not be made by counting the number of stars but qualitatively&#44; by the individual component of each item&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">The definition of externalizing and internalizing problems<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">17</span></a> and the evaluation of children and adolescents by validated scales were considered to score the outcome items &#40;in the cohort studies&#41; and exposure &#40;for case&#8211;control studies&#41;&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">As some characteristics of the mothers &#40;mental health&#44; alcohol&#44; and drug use&#41; are considered risk factors for the children&#39;s mental health&#44;<a class="elsevierStyleCrossRefs" href="#bib0270"><span class="elsevierStyleSup">24&#44;25</span></a> these factors must be assessed through structured interviews or reliable reports for the exposure analysis item&#46; Studies that controlled for one or more of these risk factors received one or two stars in the comparability item&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Quality of evidence assessment of the articles</span><p id="par0060" class="elsevierStylePara elsevierViewall">The evaluation of the quality of evidence of the studies was carried out by two reviewers &#40;E&#46;P&#46;S&#46; and C&#46;H&#46;S&#46;A&#46;&#41;&#44; using the Grading of Recommendations&#44; Assessment&#44; Development and Evaluation &#40;GRADE&#41; method&#46; The classification of evidence is described in four levels&#44; which represent the reliability in the estimation of the observed effects&#58; high &#40;confidence that the true effect is close to the estimated is strong&#41;&#44; moderate &#40;confidence in the estimated effect is moderate&#41;&#44; low &#40;confidence in the effect is limited&#41;&#44; and very low &#40;confidence in the estimated effect is very limited&#44; and there is a significant degree of uncertainty in the findings&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">26</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">The initial classification of the quality of evidence is defined based on the study design&#46; The criteria are defined&#44; and the assessment of these aspects allows reducing or increasing the level of evidence&#46; The factors responsible for the reduction in the level of evidence are&#58; risk of bias&#44; inconsistency&#44; indirect evidence&#44; inaccuracy&#44; and publication bias&#46; If the level is not lowered&#44; the evidence from observational studies can have the confidence in the estimated effect increased&#44; considering three factors&#58; high magnitude of effect&#44; dose-response gradient&#44; and confounding factors&#46;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">27</span></a></p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Data analysis</span><p id="par0070" class="elsevierStylePara elsevierViewall">Data analysis was performed using RevMan software &#40;Review Manager &#91;Computer program&#93;&#46; Version 5&#46;3&#46; Copenhagen&#44; Denmark&#58; The Nordic Cochrane Centre&#41;&#46; Study homogeneity was evaluated through the heterogeneity test&#44; being considered homogeneous when a <span class="elsevierStyleItalic">p</span>-value<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#46;05 was found&#46; The heterogeneity index &#40;<span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span>&#41; was classified as low heterogeneity with values up to 30&#37; and as moderate&#44; with values ranging from 30 to 60&#37;&#46; The magnitude of the effect was calculated by the odds ratio &#40;OR&#41;&#44; with its 95&#37; confidence interval&#46; Due to the heterogeneity of the study populations and the time of outcome evaluation&#44; a random effect meta-analysis was performed&#46; For a study that showed the number zero for events in the control group&#44; a fixed-effect analysis was performed using the Peto&#39;s method&#46; A subgroup analysis by age groups &#40;&#60;1 to 4 years and 5 to 16 years&#41; was performed&#46;</p></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Results</span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Study selection</span><p id="par0075" class="elsevierStylePara elsevierViewall">The database search retrieved a total of 5593 studies&#44; of which 687 were selected for a more detailed evaluation&#46; After the study selection and application of the eligibility criteria&#44; seven studies<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">3&#44;5&#44;16&#44;20&#44;28&#8211;30</span></a> were included &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Study characteristics</span><p id="par0080" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> shows the characteristics of the included studies&#44; published in four countries between 2006 and 2015&#44; of which four<a class="elsevierStyleCrossRefs" href="#bib0250"><span class="elsevierStyleSup">20&#44;28&#8211;30</span></a> were carried out in the United States&#46; There was a predominance of cohort studies and only one study<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">5</span></a> had a case&#8211;control design&#46; Two studies described population-based samples<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">3&#44;30</span></a> and the other five studies included samples from shelters and legal services&#44;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">29</span></a> health services&#44;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">16</span></a> and several community services&#46;<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">5&#44;20&#44;28</span></a></p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">The studies included children and adolescents aged 10 months to 16 years&#44; whereas maternal age ranged from 18 to 37 years&#46; Male children were more frequent in five studies&#46;<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">3&#44;5&#44;16&#44;20&#44;28</span></a> The salivary and plasma cortisol levels of children were evaluated in two studies&#46;<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">16&#44;28</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">The summary of the risk of bias analysis for the cohort studies<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">3&#44;16&#44;20&#44;29&#44;30</span></a> and the case&#8211;control study<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">5</span></a> included in this review&#44; is described in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Exposure was evaluated by standardized tools in five studies<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">5&#44;16&#44;20&#44;28&#44;29</span></a> and the other two<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">3&#44;30</span></a> used their own questionnaires&#46; Three studies<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">16&#44;20&#44;29</span></a> assessed the three types of violence &#40;psychological&#44; physical&#44; and sexual&#41;&#44; and physical violence was evaluated by all of them&#46; Studies that did not use a standardized tool to assess exposure<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">3&#44;30</span></a> contributed with the highest percentages in the meta-analysis to behavioral<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">3</span></a> &#40;44&#46;7&#37;&#41;&#44; externalizing<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">30</span></a> &#40;60&#46;8&#37;&#41;&#44; and internalizing<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">30</span></a> problems &#40;57&#46;6&#37;&#41;&#44; due to the large sample size&#44; in addition to the small percentage of losses&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">The evaluation interval during pregnancy varied among the studies&#46; Four studies<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">3&#44;16&#44;20&#44;28</span></a> carried out only one evaluation&#44; one study<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">5</span></a> evaluated every trimester&#44; and another study<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">29</span></a> assessed every four months&#46; Only one study carried out an interview one year after delivery&#46;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">30</span></a> Therefore&#44; the establishment of exposure&#44; <span class="elsevierStyleItalic">i&#46;e</span>&#46;&#44; IPV during pregnancy&#44; was considered adequate&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">The outcome &#40;behavioral problems&#41; was assessed using standardized tools in all studies&#46; Four studies evaluated internalizing and externalizing problems&#44;<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">5&#44;28&#8211;30</span></a> one study evaluated only externalizing problems<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">20</span></a> and two studies<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">3&#44;16</span></a> assessed the total of the problems&#46; The follow-up of the cohort studies<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">3&#44;16&#44;20&#44;29&#44;30</span></a> indicates that the time was sufficient for the outcome to occur&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">The number of losses at follow-up was higher than 10&#37; in five studies<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">3&#44;5&#44;20&#44;28&#44;30</span></a>&#59; in three of them&#44;<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">3&#44;20&#44;28</span></a> the data input technique was used to minimize loss bias&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">All studies selected exposed and unexposed individuals from the same sample&#46; The assessment of confounding factors varied among the studies and included socioeconomic and demographic factors and mental health&#44;<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">3&#44;20&#44;28&#8211;30</span></a> use of alcohol&#44; tobacco and illicit drugs during pregnancy&#44;<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">3&#44;5&#44;30</span></a> postnatal violence&#44;<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">3&#44;5&#44;20&#44;28&#44;29</span></a> social support and parental style&#44;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">20</span></a> unplanned pregnancy&#44;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">16</span></a> stressful life events&#44;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">3</span></a> child&#39;s gender and gestational age&#44;<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">3&#44;16</span></a> and birth weight&#46;<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">16&#44;30</span></a></p><p id="par0120" class="elsevierStylePara elsevierViewall">The quality of evidence of the outcomes &#40;behavioral&#44; externalizing and&#47;or internalizing problems&#41; evaluated by GRADE was classified as low &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0125" class="elsevierStylePara elsevierViewall">Three meta-analyses were performed &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41; to assess whether the mother&#39;s exposure to IPV during pregnancy increases the child&#39;s chance of showing behavioral&#44; externalizing and&#47;or internalizing problems&#44; with analysis of two age range subgroups &#40;&#60;1 to 4 years and 5 to 16 years&#41; compared to children of unexposed mothers&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0130" class="elsevierStylePara elsevierViewall">Four studies<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">3&#44;28&#8211;30</span></a> allowed a meta-analysis to be performed&#44; which identified a 1&#46;82-fold higher chance of the child having behavioral problems &#40;11&#44;683 participants&#44; OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;82&#44; 95&#37; CI&#58; 1&#46;28&#8211;2&#46;60&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;0009&#59; random effect&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;14&#44; <span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>45&#37;&#41;&#46; The other studies<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">5&#44;16&#44;20</span></a> did not provide sufficient information on the exposed and unexposed groups to be included in the meta-analysis and are described individually in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">For the internalizing problems&#44; data from four studies<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">5&#44;28&#8211;30</span></a> were analyzed and the meta-analysis showed a 2&#46;10-fold higher chance &#40;2943 participants&#59; OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#46;10&#59; 95&#37;CI&#58; 1&#46;17&#8211;3&#46;76&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#44; random effect&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;28&#44; <span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>21&#37;&#41;&#46; The same studies analyzed the externalizing problems&#44; and the chance was 1&#46;9-fold higher &#40;2943 participants&#59; OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;90&#44; 95&#37; CI&#58; 1&#46;28&#8211;2&#46;83&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;002&#59; Peto&#39;s fixed effect&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;11&#44; <span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>50&#37;&#41;&#46; <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> describes the studies<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">3&#44;16&#44;20</span></a> that were not included in the meta-analysis due to insufficient information on the exposed and unexposed groups&#46;</p></span></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Discussion</span><p id="par0140" class="elsevierStylePara elsevierViewall">The results of this review indicate that women&#39;s exposure to IPV during pregnancy during pregnancy increases the chance of children exhibiting behavioral problems when compared to the children of unexposed mothers&#44; both in the analysis of behavioral problems and in the internalizing and externalizing problems&#44; analyzed separately&#46; However&#44; this evidence should be interpreted with caution&#44; since it has low quality&#46; The GRADE method<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">26</span></a> initially classifies the observational studies with low quality of evidence&#59; the possible factors that could increase this quality were not met by the included studies&#44; demonstrating a low confidence in the estimated observed effect&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Regarding the outcome of behavioral problems&#44; although the result shows a risk increase of 82&#37;&#44; the support for this evidence is low&#44; mainly due to the inconsistency of the results and study limitations&#46; Moreover&#44; the included studies did not meet the criteria recommended by GRADE to increase the level of evidence&#44; which would be a large effect size and dose-response gradient&#46;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">27</span></a> However&#44; it is important to highlight that confounders that the literature indicate that could interfere in this association<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">12</span></a> were controlled&#44; highlighting postnatal violence&#44;<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">3&#44;5&#44;20&#44;28&#44;29</span></a> which would be a factor that depicts family dysfunction and the possibility of continuing violence in the child&#39;s life&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">Although the meta-analysis for the externalizing problem outcome showed a 90&#37; risk&#44; the quality of evidence was also low&#46; However&#44; although the studies did not show homogeneity and one of the studies<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">30</span></a> did not use a standardized tool to assess women&#39;s exposure to IPV during pregnancy&#44; this result is consistent with a study<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">13</span></a> that demonstrated the harmful effects of the prenatal environment on behavioral problems in childhood and adolescence&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">The meta-analysis showed that the children of mothers exposed to IPV during pregnancy had a 2-fold higher chance of internalizing problems&#46; The studies showed homogeneity&#44; consistency and direct evidence&#44; but one of the studies<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">30</span></a> did not use a standardized tool to evaluate the woman&#39;s exposure to IPV during pregnancy&#44; and it was not possible to increase the level of evidence&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">The children&#39;s age at the time of assessment showed great variation in the five included studies<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">3&#44;5&#44;28&#8211;30</span></a>&#59; consequently&#44; the authors decided to perform a subgroup analysis for two age groups&#46; The results were more consistent in the age range of &#60;1 to 4 years&#46; A probable explanation is the contribution of the sample size from the studies that evaluated this age range&#46; Another aspect that should be considered is that&#44; despite cerebral plasticity in the early stages of development&#44; neural circuits are more vulnerable to prenatal environment disorders than in other developmental periods&#44;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">14</span></a> and the fact that younger children process emotional experiences and traumatic events in different ways at each age&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">15</span></a></p><p id="par0165" class="elsevierStylePara elsevierViewall">Most studies were carried out in developed and Western countries&#46; However&#44; studies carried out in developing countries&#44; such as in Latin America and the Caribbean regions&#44;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">1</span></a> show a high frequency of IPV during pregnancy&#44; indicating that the consequences for children in these and other regions may be even worse&#46; Therefore&#44; the results show the need for studies that assess the effects of prenatal exposure to IPV on the development of children from developing countries and also from eastern culture countries&#44; where IPV is underreported&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">16</span></a></p><p id="par0170" class="elsevierStylePara elsevierViewall">Another important aspect is that the studies did not assess whether different types of violence &#40;physical&#44; psychological&#44; and sexual&#41; had a different impact on the children&#39;s behavior&#46; It is already well established in the literature that psychological violence in pregnancy increases the chance of maternal depression&#46;<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">7&#44;8</span></a> Although most studies controlled for maternal mental health as a confounding factor&#44; it would also be important to assess what type of violence has the greatest impact on children&#39;s behavior&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">Possible limitations of this review were the lack of access to the EMBASE database and the database of theses and dissertations&#46; In spite of the diverse databases researched for the study&#44; for any systematic review&#44; there will always be the possibility of failing to include a study difficult to be found in a certain database due to the non-inclusion of the study in the search strategy&#46; It is also necessary to consider the time-lag bias &#40;studies are being carried out&#44; but have not yet been published&#41;&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">Although the search strategy was comprehensively and carefully performed&#44; an important finding of this review is the scarcity of studies analyzing the association between children&#39;s behavioral problems and their mothers&#8217; exposure to IPV during pregnancy&#44; despite its high frequency&#46;<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">1&#44;2</span></a></p><p id="par0185" class="elsevierStylePara elsevierViewall">To the best of the authors&#8217; knowledge&#44; to date&#44; no systematic reviews have been conducted on the association between behavioral problems in children whose mothers were exposed to IPV during pregnancy&#46; The strengths of this review also comprise the inclusion of articles that assessed confounding factors and the quality of evidence evaluation using the GRADE method&#46; However&#44; it is important to emphasize that the results are based on a low quality of evidence and that&#44; therefore&#44; it is necessary to consider that for their interpretation&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Conclusion</span><p id="par0190" class="elsevierStylePara elsevierViewall">The results of this study show&#44; based on a low quality of evidence&#44; that prenatal IPV increases the chance of the child presenting behavioral&#44; internalizing&#44; and&#47;or externalizing problems&#44; with more consistent results in the age group of 1 to 4 years&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">This study also indicates the need for future research&#44; with high methodological thoroughness&#44; using standardized tools in well-defined age groups &#40;for instance&#44; infants&#44; preschoolers&#44; schoolchildren&#44; and adolescents&#41; and evaluating different types and frequency of violence&#46; Moreover&#44; it is important to control for the confounding factors &#40;such as the child&#39;s gender&#44; birth weight and gestational age&#44; social support&#44; and stressful life events&#41; and perform the analysis of stress biomarkers&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">It is necessary to analyze the associations between reactions to early adversity and contextual factors&#44; so that the environmental influences and biological susceptibilities that put the child&#39;s functioning at risk at the different stages of child development can be identified&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Conflicts of interest</span><p id="par0205" class="elsevierStylePara elsevierViewall">The authors declare no conflicts of interest&#46;</p></span></span>"
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            1 => "Prenatal"
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      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To evaluate the association of intimate partner violence during the gestational period and the development of externalizing and internalizing behavioral problems in children and adolescents&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Source of data</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A meta-analysis of cohort and case&#8211;control studies was performed&#44; using studies selected from electronic databases&#46; Eligible studies included women who experienced intimate partner violence during pregnancy and their children&#39;s behavioral problems&#46; These problems encompass two groups&#58; externalizing problems &#40;expressed by hyperactivity&#44; aggressive and challenging behavior&#44; and delinquency&#41; and internalizing problems &#40;represented by depressive moods&#44; anxiety&#44; and somatic symptoms&#41;&#46; The risk of bias was assessed by the Newcastle-Ottawa Quality Assessment Scale &#40;NOS&#41; and the quality of evidence by the Grading of Recommendations&#44; Assessment&#44; Development and Evaluation &#40;GRADE&#41;&#46; RevMan 5&#46;3 software was used for the meta-analysis&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Data synthesis</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Of the 687 eligible articles&#44; only seven met all inclusion criteria and consisted of 12&#44;250 mother&#47;child pairs&#46; The age range of the assessed children varied from 10 months to 16 years&#46; The odds of internalizing problems in children exposed to prenatal violence were two-fold higher &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#46;10&#44; 95&#37; CI&#58; 1&#46;17&#8211;3&#46;76&#41; and that of externalizing problems were 1&#46;9-fold higher &#40;95&#37; CI&#58; 1&#46;28&#8211;2&#46;83&#41;&#44; when compared to children of unexposed mothers&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The results of this study are consistent with the hypothesis that women&#39;s exposure to intimate partner violence during pregnancy may be associated with behavioral problems of their children&#44; emphasizing the need for greater understanding about the vulnerability of children to adversity in early ages&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Avaliar a associa&#231;&#227;o da viol&#234;ncia por parceiro &#237;ntimo durante o per&#237;odo gestacional e o desenvolvimento de problemas comportamentais externalizantes e internalizantes de crian&#231;as e adolescentes&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Fontes dos dados</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Foi realizada metan&#225;lise de estudos de coorte e caso-controle&#44; selecionados em bases de dados eletr&#244;nicas&#46; Os estudos eleg&#237;veis inclu&#237;ram&#58; mulheres que sofreram viol&#234;ncia pelo parceiro &#237;ntimo durante a gravidez e problemas comportamentais de seus filhos&#46; Esses problemas englobam dois grupos&#58; os problemas externalizantes &#40;que se expressam por hiperatividade&#44; comportamento agressivo e desafiante e delinqu&#234;ncia&#41; e os internalizantes &#40;representados por humor depressivo&#44; ansiedade e sintomas som&#225;ticos&#41;&#46; O risco de vi&#233;s foi avaliado pela Newcastle - Ottawa Quality Assessment Scale &#40;NOS&#41; e a qualidade da evid&#234;ncia pelo &#8220;<span class="elsevierStyleItalic">Grading of Recommendations&#44; Assessment&#44; Development and Evaluation</span>&#8221; &#40;GRADE&#41;&#46; O software RevMan 5&#46;3 foi usado para a metan&#225;lise&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">S&#237;ntese dos dados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Dos 687 artigos eleg&#237;veis&#44; apenas sete apresentaram todos os crit&#233;rios de inclus&#227;o e formaram 12&#46;250 pares de m&#227;es e filhos&#46; A faixa et&#225;ria das crian&#231;as analisadas variou de 10 meses a 16 anos&#46; A chance de problemas internalizantes das crian&#231;as&#44; expostas &#224; viol&#234;ncia pr&#233;-natal&#44; foi duas vezes maior &#40;OR &#61; 2&#44;10&#59; IC 95&#37;&#58; 1&#44;17-3&#44;76&#41; e de problemas externalizantes&#44; foi 1&#44;90 vezes maior &#40;IC 95&#37;&#58; 1&#44;28-2&#44;83&#41;&#44; quando comparada com filhos de m&#227;es n&#227;o expostas&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclus&#227;o</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Os resultados deste estudo s&#227;o consistentes com a hip&#243;tese que a exposi&#231;&#227;o da mulher a viol&#234;ncia por parceiro &#237;ntimo na gesta&#231;&#227;o pode estar associada a problemas comportamentais dos filhos&#44; destacando a necessidade de maior compreens&#227;o sobre vulnerabilidade das crian&#231;as a adversidades precoces&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0055">Please cite this article as&#58; Silva EP&#44; Lemos A&#44; Andrade CHS&#44; Ludermir AB&#46; Intimate partner violence during pregnancy and behavioral problems in children and adolescents&#58; a meta-analysis&#46; J Pediatr &#40;Rio J&#41;&#46; 2018&#59;94&#58;471&#8211;82&#46;</p>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0060">Study carried out at Universidade Federal de Pernambuco &#40;UFPE&#41;&#44; Recife&#44; PE&#44; Brazil&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="table-head ; entry_with_role_rowhead " align="left" valign="top" scope="col">Author&#44; year of publication &#40;country of study&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col">Study period&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col">Type of study&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col">Age of children and mothers&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col">Exposure assessment and evaluation period&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col">Outcome evaluation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col">Evaluated factors&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Newcastle-Ottawa scale<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a></th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Selection&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Comparability&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Outcome&#47;exposure&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Whitaker et al&#46;&#44; 2006<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">30</span></a><br>&#40;United States&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1998&#8211;2000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cohort&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Children&#58;<br>3 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Questions about physical violence at any time during pregnancy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Child Behavior Checklist &#40;CBCL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Socioeconomic and demographic factors&#44;<br>use of alcohol&#44; tobacco&#44; and illicit drugs during pregnancy&#44;<br>maternal mental health&#44;<br>child&#39;s birth weight&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;A&#42;<br>2&#46;A&#42;<br>3&#46;B&#42;<br>4&#46;A&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#46;A&#42;<br>5&#46;B&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#46;B&#42;<br>7&#46;A&#42;<br>8&#46;A&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Mothers&#58;<br>&#62;18 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 year after delivery&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">McFarlane et al&#46;&#44; 2014<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">29</span></a><br>&#40;United States&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Period not mentioned&#46;<br>Recruitment of women and children&#58; 13 months<br>Cohort duration&#58; 7 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cohort&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Children&#58;<br>18 months&#8211;13 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Severity of Violence Against Women Scale &#40;SVAWS&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">CBCL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Socioeconomic and demographic factors&#44;<br>maternal mental health&#46;<br>Compared women with reports during pregnancy and out-of-pregnancy reports&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;A&#42;<br>3&#46;B&#42;<br>4&#46;A&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#46;A&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#46;B&#42;<br>7&#46;A&#42;<br>8&#46;A&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Mothers&#58;<br>19&#8211;37 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">At every 4 months up to 24 months&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Flach et al&#46;&#44; 2011<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">3</span></a><br>&#40;United Kingdom&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Start&#58;<br>1991&#8211;1992<br>Data collection&#58;<br>42 months after the start&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cohort&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Children&#58;<br>42 months&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Questions about psychological and physical violence&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Revised Rutter Scale&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Socioeconomic and demographic factors&#44;<br>Use of alcohol and tobacco in pregnancy&#44; postnatal violence&#44;<br>maternal mental health&#44;<br>child&#39;s birth weight&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;A&#42;<br>2&#46;A&#42;<br>3&#46;B&#42;<br>4&#46;A&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#46;A&#42;<br>5&#46;B&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#46;B&#42;<br>7&#46;A&#42;<br>8&#46;B&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Mothers&#58;<br>29 years &#40;mean&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">18 weeks of gestation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Martinez-Torteya et al&#46;&#44; 2015<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">28</span></a><br>&#40;United States&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Start&#58;<br>1999&#8211;2000<br>Data collection&#58; from 1 year until 10 years after the start&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cohort&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Children&#58;<br>10 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Conflict Tactics Scales &#40;CTS&#41; e SVAWS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">CBCL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Socioeconomic and demographic factors&#44;<br>maternal life events&#44;<br>mental health&#44;<br>postnatal violence&#44;<br>cortisol in the child&#39;s saliva&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;B&#42;<br>2&#46;A&#42;<br>3&#46;B&#42;<br>4&#46;A&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#46;A&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#46;B&#42;<br>7&#46;A&#42;<br>8&#46;B&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Mothers&#58;<br>26&#46;8 years &#40;mean&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Interview in the last trimester of pregnancy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Zou et al&#46;&#44; 2015<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">16</span></a><br>&#40;China&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2006&#8211;2007&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cohort&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Children&#58;<br>10 months&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Abuse Assessment Screen &#40;AAS&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Bayley scale&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Socioeconomic and demographic factors&#44;<br>Gestational age&#44;<br>Unplanned pregnancy&#44;<br>Previous abortion&#44;<br>Plasma levels of Glu&#44; GABA&#44; and cortisol&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;B&#42;<br>2&#46;A&#42;<br>3&#46;B&#42;<br>4&#46;A&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#46;A&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#46;B&#42;<br>7&#46;A&#42;<br>8&#46;B&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Mothers&#58;<br>27 years &#40;mean&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">During hospitalization for childbirth&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Levendosky et al&#46;&#44; 2006<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">20</span></a><br>&#40;United States&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Start&#58;<br>1999&#8211;2000<br>Data collection&#58; 1 year after the start&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cohort&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Children&#58;<br>1 year&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SVAWS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Infant Toddler Social and Emotional Assessment &#40;ITSEA&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Socioeconomic and demographic factors&#44;<br>maternal mental health<br>social support&#44;<br>parental style&#44;<br>postnatal violence&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;B&#42;<br>2&#46;A&#42;<br>3&#46;B&#42;<br>4&#46;A&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#46;A&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#46;B&#42;<br>7&#46;A&#42;<br>8&#46;B&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Mothers&#58;<br>26&#46;8 years &#40;mean&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Interview in the last trimester of pregnancy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Tan and Gregor&#44; 2006<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">5</span></a><br>&#40;Canada&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Period not mentioned&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Case&#8211;control&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Children&#58;<br>3&#8211;16 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Variation of the Abuse Assessment Screen &#40;AAS&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Conners&#8217; Parent Rating Scale-Revised&#58; Long Form &#40;CPRS-R&#58;L&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">The children were matched by age and gender and no report of physical or sexual violence or witnessing violence in the family&#46;<br>Mothers were matched by age&#44; geographic region&#44; violence during pregnancy&#44; and no physical or sexual violence after the child was 3 years old&#46;<br>Marital status&#44; ethnicity&#44;<br>use of alcohol&#44; or illicit drugs during pregnancy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;A&#42;<br>3&#46;A&#42;<br>4&#46;A&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#46;A&#42;<br>5&#46;B&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#46;B&#42;<br>7&#46;A&#42;<br>8&#46;A&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Mothers&#58;<br>Cases&#58;<br>33&#46;6 years Controls&#58; 35&#46;5 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Every pregnancy trimester&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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              "identificador" => "tblfn0005"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Newcastle-Ottawa scale &#40;the score is calculated by the number of &#42;&#41;&#46;</p> <p class="elsevierStyleNotepara" id="npar0010">Case&#8211;control studies&#58; Selection&#58; 1&#46; Is the case definition adequate&#63; 2&#46; Case representativeness&#59; 3&#46; Control selection&#59; 4&#46; Control definition&#46; Comparability&#58; 5&#46; Comparability of cases and controls based on study design or analysis&#46; Exposure&#58; 6&#46; Exposure assessment&#59; 7&#46; Same evaluation method for cases and controls&#59; 8&#46; Non-response rate&#46;</p> <p class="elsevierStyleNotepara" id="npar0015">Cohort studies&#58; Selection&#58; 1&#46; Representativeness of the exposed cohort&#59; 2&#46; Selection of the unexposed cohort&#59; 3&#46; Exposure determination&#59; 4&#46; Demonstration that the outcome of interest was not present at the start of the study&#46; Comparability&#58; 5&#46; Comparability of cohorts based on study design or analysis&#46; Outcome&#58; 6&#46; Outcome evaluation&#59; 7&#46; The follow-up was long enough for the results to occur&#59; 8&#46; Adequacy of cohort follow-up&#46;</p>"
            ]
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        "descripcion" => array:1 [
          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Characteristics of studies on exposure to intimate partner violence in pregnancy and behavioral problems of children&#44; 2006&#8211;2015&#46;</p>"
        ]
      ]
      3 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
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        "detalles" => array:1 [
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            "identificador" => "at2"
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          "leyenda" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">The basis for the <span class="elsevierStyleItalic">assumed risk</span> &#40;<span class="elsevierStyleItalic">e&#46;g</span>&#46;&#44; the median control group risk across studies&#41; is provided in footnotes&#46; The <span class="elsevierStyleItalic">corresponding risk</span> &#40;and its 95&#37; confidence interval&#41; is based on the assumed risk in the comparison group and the <span class="elsevierStyleItalic">relative effect</span> of the intervention &#40;and its 95&#37; CI&#41;&#46;</p><p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">CI&#44; confidence interval&#59; OR&#44; odds ratio&#46;</p><p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">GRADE Working Group grades of evidence&#46;</p><p id="spar0095" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">High quality</span>&#58; Further research is very unlikely to change the confidence in the estimate of effect&#46;</p><p id="spar0100" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Moderate quality</span>&#58; Further research is likely to have an important impact on the confidence in the estimate of effect and may change the estimate&#46;</p><p id="spar0105" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Low quality</span>&#58; Further research is very likely to have an important impact on the confidence in the estimate of effect and is likely to change the estimate&#46;</p><p id="spar0110" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Very low quality</span>&#58; The authors are very uncertain about the estimate&#46;</p>"
          "tablatextoimagen" => array:1 [
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " colspan="7" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Population&#58; Children with internalizing and&#47;or externalizing behavioral problems</th></tr><tr title="table-row"><th class="td" title="table-head  " colspan="7" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Exposure&#58; Intimate partner violence during pregnancy</th></tr><tr title="table-row"><th class="td-with-role" title="table-head ; entry_with_role_rowhead " align="left" valign="top" scope="col">Outcomes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Illustrative comparative risks &#40;95&#37; CI&#41;</th><th class="td" title="table-head  " align="left" valign="top" scope="col">Relative effect &#40;95&#37; CI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col">No&#46; of participants &#40;studies&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col">Quality of the evidence &#40;GRADE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col">Comments&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col">Assumed risk&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col">Corresponding risk&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Control&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " rowspan="6" align="left" valign="middle"><span class="elsevierStyleItalic">Behavioral problems</span><br>Measured by CBCL and Rutter Scales<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a> Follow-up&#58; 1&#8211;10 years</td><td class="td" title="table-entry  " colspan="2" align="left" valign="top">Study population</td><td class="td" title="table-entry  " rowspan="6" align="left" valign="middle">1&#46;82 &#40;1&#46;28&#8211;2&#46;6&#41;</td><td class="td" title="table-entry  " rowspan="6" align="left" valign="middle">11&#44;677 &#40;4 studies&#41;</td><td class="td" title="table-entry  " rowspan="6" align="left" valign="middle">&#8853;&#8853;&#8861;&#8861; low<a class="elsevierStyleCrossRefs" href="#tblfn0020"><span class="elsevierStyleSup">c&#44;d</span></a></td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">143 per 1000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">261 per 1000 &#40;183&#8211;373&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top">Low</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">137 per 1000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">250 per 1000 &#40;176&#8211;357&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top">High</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">500 per 1000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">910 per 1000 &#40;640&#8211;1000&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="6" align="left" valign="middle"><span class="elsevierStyleItalic">Internalizing problems</span><br>Measured by CBCL and Rutter Scales<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a> Follow-up&#58; 1&#8211;10 years</td><td class="td" title="table-entry  " colspan="2" align="left" valign="top">Study population</td><td class="td" title="table-entry  " rowspan="6" align="left" valign="middle">OR 2&#46;10 &#40;1&#46;17&#8211;3&#46;76&#41;<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">e</span></a></td><td class="td" title="table-entry  " rowspan="6" align="left" valign="middle">2943 &#40;4 studies&#41;</td><td class="td" title="table-entry  " rowspan="6" align="left" valign="middle">&#8853;&#8853;&#8861;&#8861; low<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">c</span></a></td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">122 per 1000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">226 per 1000 &#40;140&#8211;343&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top">Low</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">213 per 1000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">362 per 1000 &#40;241&#8211;504&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top">High</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">497 per 1000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">675 per 1000 &#40;536&#8211;788&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="6" align="left" valign="middle"><span class="elsevierStyleItalic">Externalizing problems</span><br>Measured by CBCL and Rutter Scales<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a> Follow-up&#58; 1&#8211;10 years</td><td class="td" title="table-entry  " colspan="2" align="left" valign="top">Study population<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">b</span></a></td><td class="td" title="table-entry  " rowspan="6" align="left" valign="middle">OR 1&#46;90 &#40;1&#46;28&#8211;2&#46;83&#41;</td><td class="td" title="table-entry  " rowspan="6" align="left" valign="middle">2943 &#40;4 studies&#41;</td><td class="td" title="table-entry  " rowspan="6" align="left" valign="middle">&#8853;&#8853;&#8861;&#8861; low<a class="elsevierStyleCrossRefs" href="#tblfn0020"><span class="elsevierStyleSup">c&#44;f</span></a></td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">201 per 1000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">323 per 1000 &#40;243&#8211;416&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top">Low<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">b</span></a></td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">296 per 1000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">444 per 1000 &#40;350&#8211;543&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top">High<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">b</span></a></td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">364 per 1000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">521 per 1000 &#40;423&#8211;618&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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              "identificador" => "tblfn0010"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0020">CBCL&#44; Child Behavior Checklist&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0015"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0025">It was adopted as assumed risk in the control&#44; the second highest and second lowest risk of the control group in the included studies&#46;</p>"
            ]
            2 => array:3 [
              "identificador" => "tblfn0020"
              "etiqueta" => "c"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0030">Two studies evaluated exposure using a non-standard instrument&#46;</p>"
            ]
            3 => array:3 [
              "identificador" => "tblfn0025"
              "etiqueta" => "d"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0035">There was inconsistency in the results&#46; <span class="elsevierStyleItalic">p</span>-Value<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;14 and heterogeneity index of 45&#37;&#46;</p>"
            ]
            4 => array:3 [
              "identificador" => "tblfn0030"
              "etiqueta" => "e"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0040">The effect size was large &#40;&#62;2&#41;&#46;</p>"
            ]
            5 => array:3 [
              "identificador" => "tblfn0035"
              "etiqueta" => "f"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0045">There was inconsistency in the results&#46; <span class="elsevierStyleItalic">p</span>-Value<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;08 and heterogeneity index of 50&#37;&#46;</p> <p class="elsevierStyleNotepara" id="npar0050"><span class="elsevierStyleItalic">Source</span>&#58; Created by GRADE working group &#8211; <a class="elsevierStyleInterRef" target="_blank" id="intr0005" href="http://www.gradeworkinggroup.org/">http&#58;&#47;&#47;www&#46;gradeworkinggroup&#46;org</a>&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Grading of the Recommendations&#44; Assessment&#44; Development and Evaluation Evidence Profile &#40;GRADE&#41; for violence during pregnancy as a risk factor for behavioral problems in children&#44; 2006&#8211;2016&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:30 [
            0 => array:3 [
              "identificador" => "bib0155"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Maternal and fetal outcomes of intimate partner violence associated with pregnancy in the Latin American and Caribbean region"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "A&#46; Han"
                            1 => "D&#46;E&#46; Stewart"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Int J Gynecol Obstet"
                        "fecha" => "2014"
                        "volumen" => "124"
                        "paginaInicial" => "6"
                        "paginaFinal" => "11"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0160"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Violence against pregnant women&#58; prevalence&#44; patterns&#44; risk factors&#44; theories&#44; and directions for future research"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "T&#46;L&#46; Taillieu"
                            1 => "D&#46;A&#46; Brownridge"
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