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Pérez‐Aronsson A, Inge E, Alanbari H, Alsalamah I, Ghannoum M, Mohammad ZA, Metso FJ, Holmqvist F, Belachew J, Filén T, Hennoks FP, Sarkadi A, Warner G. Co-Design Workshops to Develop a Psychosocial Support Service Model for Refugees in Sweden Affected by Gender-Based Violence. Health Expect 2024; 27:e14177. [PMID: 39129706 PMCID: PMC11317807 DOI: 10.1111/hex.14177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 07/26/2024] [Accepted: 07/27/2024] [Indexed: 08/13/2024] Open
Abstract
BACKGROUND Experiencing gender-based violence (GBV) is common among refugees. Intersecting systems of oppression can increase the risk of GBV and of suffering detrimental consequences, while concurrently creating barriers to meaningful support. Despite this, refugees with lived experience of GBV are rarely involved in the development, planning and adaptation of services and policies. METHODS This article reports on a formative research process that aimed to involve public contributors (refugee victim-survivors of GBV) and relevant stakeholders in co-designing a service model aimed at improving psychosocial support in Sweden. Led by a partnership of public contributors and academic researchers, the research process consisted of iterative cycles of co-design workshops, complemented by scoping of existing literature. RESULTS The co-design process resulted in a characterisation of the psychosocial service system needs, as perceived by the survivor co-researchers and stakeholders, and a two-level empowerment and support service model. The model included (i) a community-based intervention to promote help-seeking and (ii) psychosocial group support delivered in specialist clinics. Outcomes of the project included perceived benefits for those involved, service-led direct changes and acquisition of funding for continued research on the co-designed model. CONCLUSION Improving psychosocial support for refugees in Sweden affected by GBV requires safe spaces to connect with peers and familiarise with available services, laws and rights in the society. Further, strengthened collaborations across sectors are necessary to meet the variety of needs. Co-design workshops were an effective way to initiate changes in the service delivery model for psychosocial support for refugees in Sweden affected by GBV. PATIENT OR PUBLIC CONTRIBUTIONS This is a participatory reflection on a participatory process. The survivor co-researchers contributed to designing and carrying out the PPI process and have co-authored this manuscript.
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Affiliation(s)
- Anna Pérez‐Aronsson
- Child Health and Parenting (CHAP), Department of Public Health and Caring ScienceUppsala UniversityUppsalaSweden
- Centre for Women's Mental Health During the Reproductive Lifespan—WOMHERUppsala UniversityUppsalaSweden
| | - Elin Inge
- Child Health and Parenting (CHAP), Department of Public Health and Caring ScienceUppsala UniversityUppsalaSweden
| | - Heba Alanbari
- Child Health and Parenting (CHAP), Department of Public Health and Caring ScienceUppsala UniversityUppsalaSweden
| | - Iman Alsalamah
- Child Health and Parenting (CHAP), Department of Public Health and Caring ScienceUppsala UniversityUppsalaSweden
| | - Miras Ghannoum
- Child Health and Parenting (CHAP), Department of Public Health and Caring ScienceUppsala UniversityUppsalaSweden
| | - Zozan Abu Mohammad
- Child Health and Parenting (CHAP), Department of Public Health and Caring ScienceUppsala UniversityUppsalaSweden
| | - Frida Johansson Metso
- Swedish Red Cross Competence Centre for Rehabilitation of Torture and War TraumaStockholmSweden
| | - Frida Holmqvist
- Information SwedenCounty Administrative Boards of Västra GötalandGothenburgSweden
| | - Johanna Belachew
- Kvinnofridsmottagningen (Outpatient Clinic for Women Subjected to Violence), Uppsala University Hospital, Region Uppsala, and National Centre for Knowledge on Men's Violence Against Women (NCK)Uppsala UniversityUppsalaSweden
| | - Tove Filén
- Kvinnofridsmottagningen (Outpatient Clinic for Women Subjected to Violence), Uppsala University Hospital, Region Uppsala, and National Centre for Knowledge on Men's Violence Against Women (NCK)Uppsala UniversityUppsalaSweden
| | - Frida Pålsson Hennoks
- Kvinnofridsmottagningen (Outpatient Clinic for Women Subjected to Violence), Uppsala University Hospital, Region Uppsala, and National Centre for Knowledge on Men's Violence Against Women (NCK)Uppsala UniversityUppsalaSweden
| | - Anna Sarkadi
- Child Health and Parenting (CHAP), Department of Public Health and Caring ScienceUppsala UniversityUppsalaSweden
| | - Georgina Warner
- Child Health and Parenting (CHAP), Department of Public Health and Caring ScienceUppsala UniversityUppsalaSweden
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Samms-Vaughan M, Coore-Desai C, Reece JA, Pellington S. Epidemiology of violence against young children in Jamaica. PSYCHOL HEALTH MED 2024; 29:1155-1164. [PMID: 38776979 DOI: 10.1080/13548506.2024.2342585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 04/04/2024] [Indexed: 05/25/2024]
Abstract
Violence against young children is known to have detrimental short and long-term effects. Yet, few studies investigate the prevalence of violence against young children, particularly very young children under the age of 2 years. This paper reports on the prevalence of violence against young children in Jamaica using data obtained from the JA KIDS birth cohort study that undertook pre-enrolment of pregnant mothers in the antenatal period and followed full or sub-samples of parents and children at 9-12 months, 18-22 months and 4-5 years. Violence in pregnancy was experienced by 6.1% of pre-enrolled mothers. As many as 43.1% of Jamaican children ages 9-12 months were shouted at, and almost 30% were slapped. Physical and emotional violence increased with age, and by 4-5 years, approximately 90% of children experienced physical and emotional violence. Non-violent methods, primarily explaining and reasoning with children, were also reported by more than 95% of parents at 4-5 years. Corporal punishment was the most common form of violence experienced, but young children also witnessed hurtful physical and emotional violence between mothers and their partners and lived in communities in which there were violent events. Strategies to reduce young children's experiences as victims and witnesses of violence are discussed.
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Affiliation(s)
- Maureen Samms-Vaughan
- Department of Child and Adolescent Health, The University of the West Indies, Kingston, Jamaica
| | - Charlene Coore-Desai
- Department of Child and Adolescent Health, The University of the West Indies, Kingston, Jamaica
| | - Jody-Ann Reece
- Department of Child and Adolescent Health, The University of the West Indies, Kingston, Jamaica
| | - Sydonnie Pellington
- Department of Child and Adolescent Health, The University of the West Indies, Kingston, Jamaica
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Sabri B, Mani SS, Kaduluri VPS. Integrated domestic violence and reproductive health interventions in India: a systematic review. Reprod Health 2024; 21:94. [PMID: 38951870 PMCID: PMC11218333 DOI: 10.1186/s12978-024-01830-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 06/12/2024] [Indexed: 07/03/2024] Open
Abstract
BACKGROUND Domestic violence is a leading cause of poor health outcomes during pregnancy and the postpartum period. Therefore, there is a need for integrated domestic violence interventions in reproductive health care settings. India has one of the highest maternal and child mortality rates. This review aimed to identify characteristics of existing evidence-based integrated domestic violence and reproductive healthcare interventions in India to identify gaps and components of interventions that demonstrate effectiveness for addressing domestic violence. METHODS A systematic review of intervention studies was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Three research team members performed independent screening of title, abstracts and full-texts. RESULTS The search resulted in 633 articles, of which 13 articles met inclusion criteria for full text screening and analysis. Common components of integrated violence and reproductive health interventions that were effective in addressing domestic violence included: psychoeducation/education (n = 5), skill building (n = 5), counseling (n = 5), engaging stakeholders with use of trained lay peer facilitators (n = 3), and engaging male spouses (n = 3). CONCLUSIONS Interventions in India for domestic violence that are integrated with reproductive health care remain few, and there are fewer with effective outcomes for domestic violence. Of those with effective outcomes, all of the interventions utilized psychoeducation/education, skill building, and counseling as part of the intervention.
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Affiliation(s)
- Bushra Sabri
- Johns Hopkins University School of Nursing, 525 North Wolfe Street, Room N530L, Baltimore, MD, 21205, USA.
| | - Serena Sloka Mani
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
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Jalili M, Kohan S, Tarrahi MJ, Torabi F. Correlation Between Intimate Partner Violence During Pregnancy and Parental Acceptance by Primiparous Mothers. IRANIAN JOURNAL OF MEDICAL SCIENCES 2024; 49:101-109. [PMID: 38356486 PMCID: PMC10862110 DOI: 10.30476/ijms.2023.97325.2903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 01/19/2023] [Accepted: 03/03/2023] [Indexed: 02/16/2024]
Abstract
Background Pregnancy and the transition to parenthood are periods in parents' lives that require tremendous adjustment. The physical and mental health of mothers during these periods is significantly associated with maternal acceptance. The present study aimed to evaluate the correlation between intimate partner violence (IPV) during pregnancy and parental acceptance by primiparous mothers in Isfahan, Iran. Methods A cross-sectional descriptive and correlational study was conducted from September 2021 to February 2022 in Isfahan, Iran. The target population was primiparous mothers in the postpartum period referred to nine different health centers across Isfahan. The participants (n=308) completed three questionnaires, namely demographic, Tabrizi intimate partner violence screening, and parental acceptance questionnaire. Data were analyzed using descriptive and inferential statistics with SPSS software (version 22.0). P<0.05 was considered statistically significant. Results The mean score of total IPV was 40.45±28.94. Domestic violence during pregnancy was reported by 59 (19.2%) mothers. The most common types were psychological violence (74.4%), followed by financial abuse (35.1%), sexual violence (17.2%), and physical violence (14.9%). The mean score of parental acceptance was 115.77±12.58. There was a significant inverse correlation between parental acceptance and IPV score (r=-0.15, P=0.005). The number of siblings and birth order had a significant inverse correlation with parental acceptance (r=-0.13, P=0.002; r=-0.13, P=0.002, respectively). Moreover, the age difference between the mothers and their next siblings had a significant direct correlation with parental acceptance (r=0.12, P=0.003). Conclusion Primiparous mothers subjected to IPV during pregnancy had lower parental acceptance after delivery.
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Affiliation(s)
- Masomah Jalili
- Department of Midwifery, School of Nursing and Midwifery, Reproductive Sciences and Sexual Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shahnaz Kohan
- Department of Midwifery, School of Nursing and Midwifery, Reproductive Sciences and Sexual Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Javad Tarrahi
- Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Torabi
- Reproductive Sciences and Sexual Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Mead JS, Pollack CC, Paris AE, Emeny RT, Puleo RA, St Ivany AR. Obstetric Outcomes Among Women With a History of Intimate Partner Violence in the United States. Obstet Gynecol 2023; 142:80-89. [PMID: 37290101 PMCID: PMC10330567 DOI: 10.1097/aog.0000000000005216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 03/16/2023] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To evaluate the association between exposure to intimate partner violence (IPV) and delivery method in a U.S. obstetric cohort. METHODS The study population included U.S. women with a history of recent live birth, drawn from the 2009-2018 PRAMS (Pregnancy Risk Assessment Monitoring System) cohort. The primary exposure was self-reported IPV. The primary outcome of interest was method of delivery (vaginal or cesarean). Secondary outcomes included preterm birth, small for gestational age (SGA), and admission to the neonatal intensive care unit (NICU). Bivariate associations between the primary exposure (ie, self-report of IPV vs no self-report of IPV) and each covariate of interest were assessed with weighted quasibinomial logistic regression. Weighted multivariable logistic regression was conducted to evaluate the association between IPV and delivery method controlling for confounders. RESULTS A total of 130,000 women were included in this secondary analysis of a cross-sectional sample, representing 7,500,000 women nationwide based on PRAMS sampling design. Of these, 0.8% reported abuse in the 12 months before their current pregnancy and 1.3% reported abuse during pregnancy; 1.6% of the study population reported abuse both before and during pregnancy. After adjusting for maternal sociodemographic characteristics, IPV exposure at any time was not significantly associated with cesarean delivery, compared with no IPV exposure (odds ratio [OR] 0.98, 95% CI 0.86-1.11). Of secondary outcomes, 9.4% of women experienced preterm birth and 15.1% had neonates admitted to the NICU. Exposure to IPV was associated with a 21.0% increased risk of preterm birth, compared with women without exposure (OR 1.21, 95% CI 1.05-1.40), and a 33.3% increased risk of NICU admission (OR 1.33, 95% CI 1.17-1.52) after controlling for confounders. There was no difference in the risk of delivering a neonate who was SGA. CONCLUSION Intimate partner violence was not associated with an increased risk of cesarean delivery. Intimate partner violence before or during pregnancy was associated with increased risk of adverse obstetric outcomes, such as preterm birth and NICU admission, corroborating previous research findings.
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Affiliation(s)
- Julia S Mead
- Department of Obstetrics and Gynecology, Concord Hospital, Concord, the Department of Obstetrics and Gynecology, the Department of Epidemiology, and the Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Hanover, and the Department of Obstetrics and Gynecology and the Department of Pediatrics, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire; and the Department of Internal Medicine, University of New Mexico Health System, Albuquerque, New Mexico
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Grünebaum A, Chervenak J, Pollet SL, Katz A, Chervenak FA. The exciting potential for ChatGPT in obstetrics and gynecology. Am J Obstet Gynecol 2023; 228:696-705. [PMID: 36924907 DOI: 10.1016/j.ajog.2023.03.009] [Citation(s) in RCA: 78] [Impact Index Per Article: 78.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/02/2023] [Accepted: 03/02/2023] [Indexed: 03/17/2023]
Abstract
Natural language processing-the branch of artificial intelligence concerned with the interaction between computers and human language-has advanced markedly in recent years with the introduction of sophisticated deep-learning models. Improved performance in natural language processing tasks, such as text and speech processing, have fueled impressive demonstrations of these models' capabilities. Perhaps no demonstration has been more impactful to date than the introduction of the publicly available online chatbot ChatGPT in November 2022 by OpenAI, which is based on a natural language processing model known as a Generative Pretrained Transformer. Through a series of questions posed by the authors about obstetrics and gynecology to ChatGPT as prompts, we evaluated the model's ability to handle clinical-related queries. Its answers demonstrated that in its current form, ChatGPT can be valuable for users who want preliminary information about virtually any topic in the field. Because its educational role is still being defined, we must recognize its limitations. Although answers were generally eloquent, informed, and lacked a significant degree of mistakes or misinformation, we also observed evidence of its weaknesses. A significant drawback is that the data on which the model has been trained are apparently not readily updated. The specific model that was assessed here, seems to not reliably (if at all) source data from after 2021. Users of ChatGPT who expect data to be more up to date need to be aware of this drawback. An inability to cite sources or to truly understand what the user is asking suggests that it has the capability to mislead. Responsible use of models like ChatGPT will be important for ensuring that they work to help but not harm users seeking information on obstetrics and gynecology.
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Affiliation(s)
- Amos Grünebaum
- Department of Obstetrics and Gynecology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Lenox Hill Hospital, New York, NY.
| | - Joseph Chervenak
- Department of Obstetrics and Gynecology, Albert Einstein College of Medicine, Montefiore Hospital, Bronx, NY
| | - Susan L Pollet
- Department of Obstetrics and Gynecology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Lenox Hill Hospital, New York, NY
| | - Adi Katz
- Department of Obstetrics and Gynecology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Lenox Hill Hospital, New York, NY
| | - Frank A Chervenak
- Department of Obstetrics and Gynecology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Lenox Hill Hospital, New York, NY
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Guo C, Wan M, Wang Y, Wang P, Tousey-Pfarrer M, Liu H, Yu L, Jian L, Zhang M, Yang Z, Ge F, Zhang J. Associations between intimate partner violence and adverse birth outcomes during pregnancy: a systematic review and meta-analysis. Front Med (Lausanne) 2023; 10:1140787. [PMID: 37265489 PMCID: PMC10230039 DOI: 10.3389/fmed.2023.1140787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 04/19/2023] [Indexed: 06/03/2023] Open
Abstract
Background Intimate partner violence (IPV) has been associated with an elevated risk of multiple adverse birth outcomes, yet little is known about how specific IPV influences adverse birth outcomes. The aim of this study was to examine the association between IPV during pregnancy and adverse birth outcomes (i.e., preterm birth, low birth weight, and stillbirth). Methods Systematic searches were conducted using four databases: EMBASE, Web of Science, PubMed, and CINAHL for observational studies published from 1 January 2011 to 31 August 2021. Two reviewers independently carried out the literature search, study selection, data extraction, assessment of the study, and risk of bias assessment; disagreements were resolved by a third reviewer. A random-effect model was used to calculate the odds ratio (OR) with a 95% confidence interval (CI) for preterm birth, low birth weight, and stillbirth. I2 statistic accompanied by chi-square p-value was used to assess heterogeneity, and funnel plot and Peter's test were used to assess publication bias. Results In total, 23 studies met the inclusion criterion. IPV was associated with preterm birth (OR = 1.84; 95% CI: 1.37-2.49; I2 = 88%), low birth weight (OR = 2.73; 95% CI: 1.66-4.48; I2 = 95%), and stillbirth (OR = 1.74; 95% CI: 0.86-3.54; I2 = 64%). We attained comparable results among all specific IPV including physical, sexual, emotional, and mixed. Conclusion Intimate partner violence and specific IPV during pregnancy were significantly associated with adverse birth outcomes, especially for physical IPV. An urgent need for greater action to prevent or intervene in IPV during pregnancy is warranted. Systematic review registration CRD42021282936, https://www.crd.york.ac.uk/prospero/.
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Affiliation(s)
- Cancan Guo
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Mengtong Wan
- School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yue Wang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
- Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Peijie Wang
- School of Education, Tianjin University, Tianjin, China
| | - Marissa Tousey-Pfarrer
- Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Haoyang Liu
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Liangming Yu
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Lingqi Jian
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Mengting Zhang
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Ziqi Yang
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Fenfen Ge
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
- Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Jun Zhang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
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Londoño Tobón A, McNicholas E, Clare CA, Ireland LD, Payne JL, Moore Simas TA, Scott RK, Becker M, Byatt N. The end of Roe v. Wade: implications for Women's mental health and care. Front Psychiatry 2023; 14:1087045. [PMID: 37215676 PMCID: PMC10196497 DOI: 10.3389/fpsyt.2023.1087045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 03/07/2023] [Indexed: 05/24/2023] Open
Abstract
The Supreme Court decision in Dobbs v. Jackson in June 2022 reversed precedent which had previously protected abortion prior to fetal viability as a universal right within the United States. This decision almost immediately led to abortion restrictions across 25 states. The resulting lack of access to abortion care for millions of pregnant people will have profound physical and mental health consequences, the full effects of which will not be realized for years to come. Approximately 1 in 5 women access abortions in the U.S. each year. These women are diverse and represent all American groups. The Supreme court decision, however, will affect populations that have and continue to be marginalized the most. Forcing pregnant individuals to carry unwanted pregnancies worsens health outcomes and mortality risk for both the perinatal individual and the offspring. The US has one of the highest maternal mortality rates and this rate is projected to increase with abortion bans. Abortion policies also interfere with appropriate medical care of pregnant people leading to less safe pregnancies for all. Beyond the physical morbidity, the psychological sequelae of carrying a forced pregnancy to term will lead to an even greater burden of maternal mental illness, exacerbating the already existing maternal mental health crisis. This perspective piece reviews the current evidence of abortion denial on women's mental health and care. Based on the current evidence, we discuss the clinical, educational, societal, research, and policy implications of the Dobbs v. Jackson Supreme Court decision.
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Affiliation(s)
- Amalia Londoño Tobón
- Department of Psychiatry, Georgetown University School of Medicine, Washington, DC, United States
| | | | - Camille A. Clare
- Department of Obstetrics and Gynecology, Downstate Health Sciences University, Brooklyn, NY, United States
| | - Luu D. Ireland
- UMass Chan Medical School, Worcester, MA, United States
- Department of Obstetrics and Gynecology, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Jennifer L. Payne
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA, United States
| | - Tiffany A. Moore Simas
- UMass Chan Medical School, Worcester, MA, United States
- Department of Obstetrics and Gynecology, University of Massachusetts Chan Medical School, Worcester, MA, United States
- Department of Psychiatry, University of Massachusetts Chan Medical School, Worcester, MA, United States
- Department of Pediatrics, University of Massachusetts Chan Medical School, Worcester, MA, United States
- Department of Population & Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Rachel K. Scott
- MedStar Health Research Institute, Georgetown University School of Medicine, Washington, DC, United States
| | - Madeleine Becker
- Departments of Psychiatry and Human Behavior, Sydney Kimmel Medical College, Integrative Medicine and Nutritional Sciences, Thomas Jefferson University, Philadelphia, PA, United States
| | - Nancy Byatt
- UMass Chan Medical School, Worcester, MA, United States
- Department of Obstetrics and Gynecology, University of Massachusetts Chan Medical School, Worcester, MA, United States
- Department of Psychiatry, University of Massachusetts Chan Medical School, Worcester, MA, United States
- Department of Pediatrics, University of Massachusetts Chan Medical School, Worcester, MA, United States
- Department of Population & Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, United States
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Improving the interpretation of electronic fetal monitoring: the fetal reserve index. Am J Obstet Gynecol 2023; 228:S1129-S1143. [PMID: 37164491 DOI: 10.1016/j.ajog.2022.11.1275] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 11/03/2022] [Accepted: 11/03/2022] [Indexed: 03/19/2023]
Abstract
Electronic fetal monitoring, particularly in the form of cardiotocography, forms the centerpiece of labor management. Initially successfully designed for stillbirth prevention, there was hope to also include prediction and prevention of fetal acidosis and its sequelae. With the routine use of electronic fetal monitoring, the cesarean delivery rate increased from <5% in the 1970s to >30% at present. Most at-risk cases produced healthy babies, resulting in part from considerable confusion as to the differences between diagnostic and screening tests. Electronic fetal monitoring is clearly a screening test. Multiple attempts have aimed at enhancing its ability to accurately distinguish babies at risk of in utero injury from those who are not and to do this in a timely manner so that appropriate intervention can be performed. Even key electronic fetal monitoring opinion leaders admit that this goal has yet to be achieved. Our group has developed a modified approach called the "Fetal Reserve Index" that contextualizes the findings of electronic fetal monitoring by formally including the presence of maternal, fetal, and obstetrical risk factors and increased uterine contraction frequencies and breaking up the tracing into 4 quantifiable components (heart rate, variability, decelerations, and accelerations). The result is a quantitative 8-point metric, with each variable being weighted equally in version 1.0. In multiple previously published refereed papers, we have shown that in head-to-head studies comparing the fetal reserve index with the American College of Obstetricians and Gynecologists' fetal heart rate categories, the fetal reserve index more accurately identifies babies born with cerebral palsy and could also reduce the rates of emergency cesarean delivery and vaginal operative deliveries. We found that the fetal reserve index scores and fetal pH and base excess actually begin to fall earlier in the first stage of labor than was commonly appreciated, and the fetal reserve index provides a good surrogate for pH and base excess values. Finally, the last fetal reserve index score before delivery combined with early analysis of neonatal heart rate and acid/base balance shows that the period of risk for neonatal neurologic impairment can continue for the first 30 minutes of life and requires much closer neonatal observation than is currently being done.
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Abujilban S, AbuAbed A, Mrayan L, Nashwan AJ, Al-Modallal H, Damra J, Alrousan D, Hamaideh S. Pregnant Women's experiences with intimate partner violence one year after the COVID-19 pandemic in Jordan. Nurs Open 2023. [PMID: 36826391 DOI: 10.1002/nop2.1669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 12/11/2022] [Accepted: 02/05/2023] [Indexed: 02/25/2023] Open
Abstract
AIM To assess the prevalence and compare the levels of intimate partner violence (IPV) before and during the pandemic and to identify the factors that associated with physical IPV among Jordanian pregnant women. DESIGN A cross-sectional, correlational design. Women were asked to report their experience with IPV twice: during and before the pandemic. METHODS A convenience sampling technique was used to select pregnant women from National Woman's Health Care Center from 15 April to 1 September 2021. The Domestic Violence Questionnaire Screening Tool (DVQST) was used to assess the levels of IPV. RESULTS The women (n = 232) who participated in the study experienced considerable levels of IPV before (69% control IPV, 59.90% psychological, 46.10% physical, 43.10% sexual) and during (75.90% control IPV, 64.20% psychological, 46.10% physical, 40.90% sexual) the pandemic. There were statistically significant (p ≤ 0.05) higher mean DVQST scores for control IPV and psychological IPV during the pandemic (control IPV mean = 9.78, psychological mean = 7.03) versus before the pandemic (control IPV mean = 8.95, psychological mean = 6.62). Woman's educational level, marriage duration, woman's employment status, and level of mutual understanding were inversely associated with physical IPV during the pandemic. PATIENT OR PUBLIC CONTRIBUTION IPV is a global public health problem and a major violation of human rights. The levels of control IPV and psychological IPV increased during the COVID-19 pandemic, while the levels of physical and sexual IPV stayed the same. Antenatal screening for IPV is crucial to save women and their offspring from suffering this type of violence.
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Affiliation(s)
- Sanaa Abujilban
- Department of Maternal, Child and Family Health Nursing, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
| | | | - Lina Mrayan
- Department of Maternal, Child and Family Health Nursing, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
| | | | - Hanan Al-Modallal
- Department of Community and Mental Health Nursing, Faculty of Nursing, The Hashemite University, Zarqa, Jordan.,Department of Nursing, Fakeeh College for Medical Sciences, Jeddah, Saudi Arabia
| | - Jalal Damra
- Department of Educational Psychology and Counseling Psychology, Hashemite University, Zarqa, Jordan
| | - Dheaya Alrousan
- Faculty of Prince AlHasan Bin Talal, The Hashemite University, Zarqa, Jordan
| | - Shaher Hamaideh
- Department of Community and Mental Health Nursing, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
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11
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Morris JR, Kawwass JF, Hipp HS. Physical intimate partner violence among women reporting prior fertility treatment: a survey of U.S. postpartum women. Fertil Steril 2023; 119:277-288. [PMID: 36347311 DOI: 10.1016/j.fertnstert.2022.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 11/01/2022] [Accepted: 11/02/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To determine the prevalence of physical intimate partner violence (IPV) among postpartum women reporting preconception fertility treatment compared with those who conceived without the use of assisted reproduction. DESIGN Retrospective cross-sectional population-based study. SETTING Not applicable. PATIENT(S) Postpartum respondents of the Centers for Disease Control Pregnancy Risk Assessment Monitoring System survey. INTERVENTION Preconception fertility treatment utilization. MAIN OUTCOME MEASURES Physical IPV. RESULTS Of the 43,999 respondents included in this analytic sample, roughly 2% reported physical IPV. Respondents reporting preconception fertility treatment (12.6%) were less likely to endorse physical IPV than those who conceived without fertility treatment exposure (odds ratio, 0.5; 95% confidence interval, 0.4-0.7). In the multivariate regression model, the odds of physical IPV were similar among postpartum women regardless of the fertility treatment exposure (adjusted odds ratio, 1.2; 95% confidence interval, 0.8-2.0). Residing in a household with an income under the federal poverty level and increased preconception stressors were predictive of reported physical IPV. There was no difference in the type of fertility treatment and report of physical IPV. Among women exposed to fertility treatment, predictors of physical IPV included self-identification of Black or Hispanic race and ethnicity as well as report of 4 or more stressors in the 12 months before the most recent delivery. CONCLUSION The use of fertility treatment did not confer greater risk of physical IPV within this postpartum population. However, there are many individuals with infertility who never present for an assessment, proceed with treatment, or are unsuccessful, thus the extent to which infertility and fertility treatment exposure is associated with physical IPV remains to be elucidated. Women reporting a greater number of stressors may be uniquely at risk despite the access and exposure to fertility treatment. The preconception period, inclusive of encounters with infertility specialists, represents a novel opportunity to screen and counsel all women for IPV.
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Affiliation(s)
- Jerrine R Morris
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California-San Francisco, San Francisco, California.
| | - Jennifer F Kawwass
- Division of Reproductive Endocrinology and Infertility, Emory University School of Medicine, Atlanta, Georgia
| | - Heather S Hipp
- Division of Reproductive Endocrinology and Infertility, Emory University School of Medicine, Atlanta, Georgia
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12
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Intimate Partner Violence and Children: Essentials for the Pediatric Nurse Practitioner. J Pediatr Health Care 2023; 37:333-346. [PMID: 36682969 DOI: 10.1016/j.pedhc.2022.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 12/16/2022] [Accepted: 12/21/2022] [Indexed: 01/21/2023]
Abstract
Intimate partner violence (IPV) is a public health problem of epidemic proportions. IPV often starts early in adolescence and continues throughout an individual's lifespan. IPV is defined as abuse or aggression occurring in the context of a romantic relationship that is perpetrated by a current or former partner. IPV victims often experience severe psychological trauma, physical injury, and even death. The direct recipient of the violence is often not the only individual impacted. Children are often peripheral victims of IPV. It is vital that pediatric health care providers, including pediatric nurse practitioners, recognize that IPV is indeed a pediatric health care crisis requiring strategies for both identification and intervention. This continuing education article will discuss IPV and its impact on children from conception to adolescence while exploring implications for practice.
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13
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Nagle-Yang S, Sachdeva J, Zhao LX, Shenai N, Shirvani N, Worley LLM, Gopalan P, Albertini ES, Spada M, Mittal L, Moore Simas TA, Byatt N. Trauma-Informed Care for Obstetric and Gynecologic Settings. Matern Child Health J 2022; 26:2362-2369. [PMID: 36346563 DOI: 10.1007/s10995-022-03518-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2022] [Indexed: 11/09/2022]
Abstract
PURPOSE Trauma is common among those seeking Ob-Gyn care and may have pervasive impact on obstetrical and gynecological health, social functioning, and healthcare engagement. While guidelines exist on the detection and treatment of perinatal mood and anxiety disorders within Ob-Gyn care, the role of Ob-gyn clinicians in identifying and addressing patients' traumatic experiences and related symptoms is less clearly delineated. This manuscript provides an overview of trauma-related symptoms in the context of Ob-Gyn care and practical guidance of clinicians aiming to improve their detection and response to trauma in their clinical practice. DESCRIPTION Posttraumatic stress disorder (PTSD) describes a psychiatric illness which develops as a response to a traumatic event. Women who have experienced trauma are also at increased risk for borderline personality disorder and other psychiatric comorbidities. Postpartum PTSD has particular relevance to obstetrical care. ASSESSMENT Screening for trauma in Ob-Gyn care can provide an opportunity to address risk and offer targeted intervention. Several brief evidence-based screening tools are available. Individuals who screen positive require assessment of immediate safety and targeted referrals. Trauma informed care describes an approach to healthcare aimed to enhance physical and emotional safety for patients and clinicians. CONCLUSION Given the prevalence and the potentially devastating and enduring impact of trauma and trauma-related symptoms, there is a critical need to address trauma within Ob-Gyn care. By recognizing the signs of trauma and initiating or referring to appropriate treatments, Ob-Gyn clinicians have a unique opportunity to better understand their patients and to improve their care.
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Affiliation(s)
- Sarah Nagle-Yang
- Department of Psychiatry, University of Colorado School of Medicine, 13001 E 17th Place; MS F546, 80045, Aurora, CO, USA.
| | - Jyoti Sachdeva
- Departments of Psychiatry and Behavioral Neuroscience and Obstetrics and Gynecology, University of Cincinnati School of Medicine, Cincinnati, OH, USA
| | - Lulu X Zhao
- Department of Obstetrics & Gynecology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Neeta Shenai
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | | | - Linda L M Worley
- Departments of Psychiatry and Obstetrics and Gynecology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Priya Gopalan
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | | | - Meredith Spada
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Leena Mittal
- Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA
| | - Tiffany A Moore Simas
- Departments of Obstetrics & Gynecology, Pediatrics, Psychiatry, and Population & Quantitative Health Sciences, University of Massachusetts Chan Medical School, UMass Memorial Health, Worcester, MA, USA
| | - Nancy Byatt
- Departments of Psychiatry, Obstetrics & Gynecology and Population & Quantitative Health Sciences, University of Massachusetts Chan Medical School, UMass Memorial Health, Worcester, MA, USA
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14
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Da Thi Tran T, Murray L, Van Vo T. Intimate partner violence during pregnancy and maternal and child health outcomes: a scoping review of the literature from low-and-middle income countries from 2016 - 2021. BMC Pregnancy Childbirth 2022; 22:315. [PMID: 35418053 PMCID: PMC9006493 DOI: 10.1186/s12884-022-04604-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 03/14/2022] [Indexed: 12/23/2022] Open
Abstract
Background Intimate partner violence (IPV) during pregnancy is significantly associated with negative outcomes for both mother and child. Current evidence indicates an association between low levels of social support and IPV, however there is less evidence from low-and-middle income countries (LMIC) than high-income countries. Globally, the COVID-19 pandemic has radically altered how women can access social support. Hence since 2020, studies investigating IPV and pregnancy have occurred within the changing social context of the pandemic. Objective This scoping review summarizes the evidence from LMICs about the effects of IPV during pregnancy on maternal and child health. The review includes the impact of the COVID-19 pandemic on social support as mentioned in studies conducted since 2020. Design Library databases were used to identify papers from 2016 to 2021. These studies reported the maternal and child health outcomes of IPV during pregnancy, and described how social support during pregnancy, and the COVID-19 pandemic, were associated with rates of IPV during pregnancy. Observational study designs, qualitative and mixed methods studies were included. Results Twenty - six studies from 13 LMICs were included. Half (n = 13) were cross sectional studies which only collected data at one time-point. IPV during pregnancy was significantly associated with higher odds of postpartum depression, low birth weight, preterm birth and less breastfeeding in the year after birth. Lower levels of social support increased the odds of experiencing IPV during pregnancy, whilst higher levels of social support reduced antenatal anxiety and depression in women experiencing IPV during pregnancy. Of the four studies that investigated IPV during pregnancy throughout the COVID-19 pandemic, only one compared prevalence before and after the pandemic and unexpectedly reported a lower prevalence. Conclusions Further research on the impact of IPV during pregnancy on maternal and child outcomes in LMICs is required, especially evidence from longitudinal studies investigating a wider range of outcomes. To date, there is limited evidence on the impact of the COVID-19 pandemic on IPV during pregnancy in LMICs, and this should be prioritized as the pandemic continues to affect women’s access to social support globally. Supplementary information The online version contains supplementary material available at 10.1186/s12884-022-04604-3.
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Affiliation(s)
- Thao Da Thi Tran
- School of Health Sciences, College of Health, Massey University, Wellington, Aotearoa, New Zealand
| | - Linda Murray
- School of Health Sciences, College of Health, Massey University, Wellington, Aotearoa, New Zealand.
| | - Thang Van Vo
- Institute for Community Health Research, University of Medicine and Pharmacy, Hue University, Hue City, Vietnam.,Faculty of Public Health, University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
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15
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Vaz JDS, Souza MEMDCD, Valério ID, Silva MTD, Freitas-Vilela AA, Bierhals IO, Hasselmann MH, Kac G. Physical intimate partner violence and dietary patterns in pregnancy: a Brazilian cohort. CIENCIA & SAUDE COLETIVA 2022; 27:1317-1326. [PMID: 35475814 DOI: 10.1590/1413-81232022274.05882021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Accepted: 06/01/2021] [Indexed: 11/21/2022] Open
Abstract
Little is known about the repercussions of intimate partner violence (IPV) on nutritional outcomes in pregnancy, especially regarding diet. The aim was to investigate whether the occurrence of physical IPV at any time during pregnancy is associated with gestational dietary patterns. 161 adult pregnant women were enrolled in a prospective cohort study in Rio de Janeiro, Brazil. Overall and severe physical IPV were measured to evaluate IPV at any time during pregnancy. Three gestational dietary patterns ("Healthy", "Common-Brazilian", and "Processed") were established by principal component analysis. The effect of physical IPV was tested in relation to the score of adherence to each of the dietary patterns. The occurrence of overall and severe physical IPV at any time during pregnancy was 20.4% and 6.8%, respectively. Women living in intimate relationships in which overall and severe physical IPV occurred had an average increase of 0.604 units (95%CI 0.149-1.058) and 1.347 units (95%CI 0.670-2.024), respectively, in the Processed dietary pattern adherence score. No association with "Healthy" and "Common-Brazilian" dietary patterns was observed. Physical IPV was associated with greater adherence to a dietary pattern of lower nutritional quality.
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Affiliation(s)
- Juliana Dos Santos Vaz
- Programa de Pós-Graduação em Nutrição e Alimentos, Faculdade de Nutrição, Universidade Federal de Pelotas (UFPel). R. Gomes Carneiro 1, Centro. 96010-610 Pelotas RS Brasil.
| | - Maria Eduarda Monteiro da Cunha de Souza
- Programa de Pós-Graduação em Nutrição e Alimentos, Faculdade de Nutrição, Universidade Federal de Pelotas (UFPel). R. Gomes Carneiro 1, Centro. 96010-610 Pelotas RS Brasil.
| | - Inae Dutra Valério
- Programa de Pós-Graduação em Epidemiologia, Departamento de Medicina Social, UFPel. Pelotas RS Brasil
| | - Manoela Teixeira da Silva
- Programa de Pós-Graduação em Nutrição e Alimentos, Faculdade de Nutrição, Universidade Federal de Pelotas (UFPel). R. Gomes Carneiro 1, Centro. 96010-610 Pelotas RS Brasil.
| | - Ana Amélia Freitas-Vilela
- Unidade Acadêmica Especial em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Jataí. Jataí GO Brasil
| | - Isabel Oliveira Bierhals
- Programa de Pós-Graduação em Epidemiologia, Departamento de Medicina Social, UFPel. Pelotas RS Brasil
| | - Maria Helena Hasselmann
- Departamento de Nutrição Social, Instituto de Nutrição, Universidade do Estado do Rio de Janeiro. Rio de Janeiro RJ Brasil
| | - Gilberto Kac
- Observatório de Epidemiologia Nutricional, Instituto de Nutrição Josué de Castro, Departamento de Nutrição Social e Aplicada, Universidade Federal do Rio de Janeiro. Rio de Janeiro RJ Brasil
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16
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Safe Pregnancy intervention for intimate partner violence: a randomised controlled trial in Norway among culturally diverse pregnant women. BMC Pregnancy Childbirth 2022; 22:144. [PMID: 35189843 PMCID: PMC8862262 DOI: 10.1186/s12884-022-04400-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 01/10/2022] [Indexed: 01/10/2023] Open
Abstract
Background Intimate partner violence (IPV) during pregnancy is a global health problem with adverse consequences for mothers, infants and families. We hypothesise that information about IPV and safety behaviours during pregnancy has the potential to increase quality of life and the use of safety behaviours and prevent IPV. Methods A multicentre randomised controlled trial among culturally diverse pregnant women in Norway, to test the effect of a tablet-based video intervention about IPV and safety behaviours. Women attending routine antenatal check-ups alone (baseline) were screened for violence (Abuse Assessment Screen) by responding to questions on a tablet, and randomised (1:1) by computer to receive an intervention or a control video. The intervention video presented information about IPV and safety behaviours. The controls viewed a video promoting healthy pregnancy in general. Outcome measures were assessed three months post-partum: The World Health Organization Quality of Life-BREF, the Composite Abuse Scale on violence during the last 12 months and use of safety behaviours based on a 15-item checklist. A general linear model for repeated measures was used to examine the intervention’s effect. The analyses were conducted by intention to treat. Results Among 1818 eligible women, 317 reported IPV and were randomised to an intervention (157) or a control group (160). A total of 251 (79.2%) women completed the follow-up questionnaire: 120 (76.4%) in the intervention group and 131 (81.9%) in the control group. At follow-up, 115 (45.8%) women reported a history of IPV. Few women (n = 39) reported IPV during the last 12 months. No differences in quality-of-life domains and overall quality of life and health were found between the intervention and the control groups. We detected no differences between the use of safety behaviours or IPV frequency and severity during the last 12 months. Conclusion Our intervention did not improve women’s quality of life, use of safety behaviours or exposure to violence. Nevertheless, a tablet-based tool may motivate women experiencing IPV to seek help and support. More research is needed regarding tablet-based interventions for women experiencing IPV, particularly culturally sensitive interventions. Trial registration NCT03397277 registered in clinicaltrials.gov on 11/01/2018. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04400-z.
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17
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Zapata-Calvente AL, Megías JL, Velasco C, Caño A, Khan KS, Rubio L, Martín-de-Las-Heras S. Screening for intimate partner violence during pregnancy: a test accuracy study. Eur J Public Health 2022; 32:429-435. [PMID: 35134894 PMCID: PMC9159325 DOI: 10.1093/eurpub/ckac009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background Intimate partner violence (IPV) against women is a serious health problem that affects pregnancy more frequently than other obstetric complications usually evaluated in antenatal visits. We aimed to estimate the accuracy of the Women Abuse Screening Tool-Short (WAST-Short) and the Abuse Assessment Screen (AAS) for the detection of IPV during and before pregnancy. Methods Consecutive eligible mothers in 21 public primary health antenatal care centres in Andalusia (Spain) who received antenatal care and gave birth during January 2017–March 2019, had IPV data gathered by trained midwives in the first and third pregnancy trimesters. The index tests were WAST-Short (score range 0–2; cut-off 2) and AAS (score range 0–1; cut-off 1). The reference standard was World Health Organization (WHO) IPV questionnaire. Area under receiver operating characteristics curve (AUC), sensitivity and specificity with 95% confidence intervals (CI) were estimated for test performance to capture IPV during and before pregnancy, and compared using paired samples analysis. Results According to the reference standard, 9.5% (47/495) and 19.4% (111/571) women suffered IPV during and before pregnancy, respectively. For capturing IPV during pregnancy in the third trimester, the WAST-Short (AUC 0.73, 95% CI 0.63, 0.81), performed better than AAS (AUC 0.57, 95% CI 0.47, 0.66, P = 0.0001). For capturing IPV before pregnancy in the first trimester, there was no significant difference between the WAST-Short (AUC 0.69, 95% CI 0.62, 0.74) and the AAS (AUC 0.69, 95% CI 0.62, 0.74, P = 0.99). Conclusions The WAST-Short could be useful to screen IPV during pregnancy in antenatal visits.
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Affiliation(s)
| | - Jesús L Megías
- Department of Experimental Psychology, University of Granada, Granada, Spain
| | - Casilda Velasco
- Department of Nursing and Midwifery, University of Jaen, Jaen, Spain
| | - Africa Caño
- Department of Obstetrics and Gynecology, University Hospital, Granada, Spain
| | - Khalid S Khan
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Granada, Spain
| | - Leticia Rubio
- Department of Forensic Medicine, University of Malaga, Malaga, Spain
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18
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Drexler KA, Quist-Nelson J, Weil AB. Intimate Partner Violence and Trauma-Informed Care in Pregnancy. Am J Obstet Gynecol MFM 2021; 4:100542. [PMID: 34864269 DOI: 10.1016/j.ajogmf.2021.100542] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 11/15/2021] [Accepted: 11/30/2021] [Indexed: 10/19/2022]
Abstract
Intimate partner violence is defined as any behavior within an intimate relationship that causes physical, psychological, or sexual harm to those in the relationship. Globally, women are disproportionately victims of intimate partner violence. The risk increases during pregnancy, with rates estimated as high as 20% among pregnant persons. Intimate partner violence is associated with adverse perinatal outcomes, including perinatal and maternal death. As pregnancy is a period of frequent interaction with the healthcare system, it is an opportune time to screen and intervene for intimate partner violence. Universal screening at the first prenatal visit and subsequently every trimester is recommended, with either written or verbal validated tools. Pregnant persons experiencing intimate partner violence need nonjudgmental, compassionate, confidential and trauma-informed care. The goal of this review is to outline pregnancy-specific care considerations.
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Affiliation(s)
- Kathleen A Drexler
- Chapel Hill, North Carolina; University of North Carolina at Chapel Hill, Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine.
| | - Johanna Quist-Nelson
- Chapel Hill, North Carolina; University of North Carolina at Chapel Hill, Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine
| | - Amy B Weil
- Chapel Hill, North Carolina; University of North Carolina at Chapel Hill, Department of Medicine, Division of General Medicine and Clinical Epidemiology
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19
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Cao J, Gallis JA, Ali M, Lillie M, Abubakr-Bibilazu S, Adam H, McEwan E, Awoonor-Williams JK, Hembling J, Baumgartner JN. The impact of a maternal mental health intervention on intimate partner violence in Northern Ghana and the mediating roles of social support and couple communication: secondary analysis of a cluster randomized controlled trial. BMC Public Health 2021; 21:2010. [PMID: 34736452 PMCID: PMC8569999 DOI: 10.1186/s12889-021-12121-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 10/28/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUNDS Diverse intervention efforts are implemented to address intimate partner violence (IPV) against women. Via a syndemics theory lens and emerging empirical evidence, mental health interventions demonstrate promise to partially ameliorate IPV. However, the mechanisms of change underlying many IPV interventions are not well understood. These gaps impede our efforts to strengthen or integrate effective components into the current mental health resources, especially in low- and middle-income countries (LMICs). This study aims to examine the impact of a maternal mental health intervention called Integrated Mothers and Babies Course & Early Childhood Development (iMBC/ECD) on IPV and whether social support and/or couple communication mediates the intervention effects among women in rural, Northern Ghana. METHODS The current study is a secondary data analysis of a cluster randomized controlled trial. IPV was measured at baseline and 8 months post-intervention (~ 19 months post-baseline). At baseline, 84.8% of the women enrolled in the study (n = 374) reported some type of IPV in the past 12 months. Logistic regression models and multiple mediation analyses were used to address the study aims. RESULTS iMBC/ECD did not reduce IPV in the intervention group compared to the control group. Social support and couple communication did not mediate the intervention effects on IPV as indicated by the indirect effects of the multiple mediation models. However, increase in social support reduced women's odds of experiencing emotional violence by 7%, odds ratio (OR) = 0.93, p = 0.007; b = - 0.07, 95% confidence interval (CI) = (- 0.13, - 0.02), and improvement in couple communication demonstrated promise in reducing women's odds of experiencing controlling behaviors by 7%, OR = 0.93, p = 0.07; b = - 0.07, CI = (- 0.14, 0.005), though the improvements were not due to the intervention. CONCLUSION This maternal mental health intervention did not reduce IPV; however, the findings extend our knowledge about the impact of such interventions on IPV and the potential mechanisms of change via social support and couple communication. Future research evaluating the impact of mental health interventions on IPV and mechanisms of change is essential for the development of effective interventions. Future programs addressing IPV in LMICs should consider risk factors beyond relationship level (e.g. poverty and gender inequity). TRIAL REGISTRATION ClinicalTrials.gov # NCT03665246 , Registered on August 20th, 2018.
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Affiliation(s)
- Jiepin Cao
- School of Nursing, Duke University, 307 Trent Drive, Durham, NC, 27705, USA.
| | - John A Gallis
- Duke Global Health Institute, Duke University, Durham, NC, USA
- Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA
| | - Mohammed Ali
- Catholic Relief Services Country Office, Tamale, Ghana
| | - Margaret Lillie
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | | | - Haliq Adam
- Catholic Relief Services Country Office, Tamale, Ghana
| | - Elena McEwan
- Catholic Relief Services Head Quarters, Baltimore, MD, USA
| | | | - John Hembling
- Catholic Relief Services Head Quarters, Baltimore, MD, USA
| | - Joy Noel Baumgartner
- School of Social Work, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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20
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Román-Gálvez RM, Martín-Peláez S, Fernández-Félix BM, Zamora J, Khan KS, Bueno-Cavanillas A. Worldwide Prevalence of Intimate Partner Violence in Pregnancy. A Systematic Review and Meta-Analysis. Front Public Health 2021; 9:738459. [PMID: 34527656 PMCID: PMC8435609 DOI: 10.3389/fpubh.2021.738459] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 08/09/2021] [Indexed: 12/30/2022] Open
Abstract
Background: Intimate partner violence (IPV) affects outcomes of mothers and their offspring. This systematic review collated the worldwide literature on the prevalence rates of different types of IPV in pregnancy. Methods: Two reviewers independently identified cross sectional and cohort studies of IPV prevalence in pregnancy in online databases (PubMed, WOS and Scopus), selected and extracted data [participants' country, study quality, measurement tool (validation and purpose) and rates of IPV in pregnancy]. We considered a high quality study if it had a prospective design, an adequate sampling method, a sample size estimation, a response rate > 90%, a contemporary ascertainment of IPV in the index pregnancy, and a well-developed detailed IPV tool. We performed random effects meta-analysis and explored reasons for heterogeneity of rates. Results: One hundred fifty-five studies were included, of which 44 (28%) met two-thirds of the quality criteria. Worldwide prevalence of physical (126 studies, 220,462 participants), psychological (113 studies, 189,630 participants) and sexual (98 studies, 155,324 participants) IPV in pregnancy was 9.2% (95% CI 7.7–11.1%, I2 95.9%), 18.7% (15.1–22.9%, I2 98.2%), 5.5% (4.0–7.5%, I2 93.4%), respectively. Where several types of IPV were reported combined, the prevalence of any kind of IPV (118 studies, 124,838 participants) was 25.0% (20.3, 30.5%, I2 98.6%). IPV rates varied within and between continents, being the highest in Africa and the lowest in Europe (p < 0.001). Rates also varied according to measurement purpose, being higher for diagnosis than for screening, in physical (p = 0.022) and sexual (p = 0.014) IPV. Conclusions: IPV prevalence in pregnancy varies across countries, with one-quarter of mothers exposed on average globally. Routine systematic antenatal detection should be applied worldwide. Systematic Review Registration: identifier: CRD42020176131.
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Affiliation(s)
- Rosario M Román-Gálvez
- Departamento de Enfermería, Facultad de Ciencias de la Salud, Universidad de Granada, Granada, Spain.,Unidad Asistencial Alhama de Granada, Servicio Andaluz de Salud, Granada, Spain
| | - Sandra Martín-Peláez
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad de Granada, Granada, Spain.,Instituto de Investigación Biosanitaria de Granada IBS, Granada, Spain
| | - Borja M Fernández-Félix
- Clinical Biostatistics Unit, Hospital Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain.,Centro de Investigación Biomédica en Red (CIBER) Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
| | - Javier Zamora
- Clinical Biostatistics Unit, Hospital Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain.,Centro de Investigación Biomédica en Red (CIBER) Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
| | - Khalid S Khan
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad de Granada, Granada, Spain.,Centro de Investigación Biomédica en Red (CIBER) Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
| | - Aurora Bueno-Cavanillas
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad de Granada, Granada, Spain.,Instituto de Investigación Biosanitaria de Granada IBS, Granada, Spain.,Centro de Investigación Biomédica en Red (CIBER) Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
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21
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Walter B, Indreboe H, Lukasse M, Henriksen L, Garnweidner-Holme L. Pregnant Women's Attitudes Toward and Experiences With a Tablet Intervention to Promote Safety Behaviors in a Randomized Controlled Trial: Qualitative Study. JMIR Form Res 2021; 5:e28680. [PMID: 34283023 PMCID: PMC8335599 DOI: 10.2196/28680] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 05/13/2021] [Accepted: 05/29/2021] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Intimate partner violence (IPV) is recognized as a global health problem. Women with low education and limited resources are more vulnerable, as are immigrant women. There is a lack of evidence on how health care professionals should communicate about and intervene against IPV during pregnancy. Earlier research has shown that when women manage digital questionnaires, they are more likely to disclose IPV. However, little is known about how women experience eHealth interventions with safety behaviors to prevent IPV. OBJECTIVE The aim of this study was to explore pregnant women's attitudes toward and experiences with a tablet intervention to promote safety behaviors in a randomized controlled trial (RCT) in antenatal care. METHODS Individual semistructured interviews were conducted with 10 women who participated in the Safe Pregnancy Study. The Safe Pregnancy Study was a randomized controlled trial (RCT) using a tablet intervention containing IPV questions and a film to promote safety behaviors. Six women from the intervention group and four women from the control group were recruited. The content was available in Norwegian, Somali, and Urdu. Five of the women participating in the interviews spoke Norwegian at home and five spoke another language. The majority of the women who did not speak Norwegian at home perceived themselves as relatively well integrated. The interviews were conducted at different maternal and child health centers (MCHCs) in Norway between March 2020 and June 2020. The analysis was guided by thematic analysis. RESULTS Women who participated in the tablet intervention appreciated being asked questions about IPV on a tablet. However, it was important to supplement the tablet intervention with face-to-face communication with a midwife. The MCHC was regarded as a suitable place to answer questions and watch a film about safety behaviors. Women suggested making the tablet intervention available in other settings where women meet health care professionals. Some women expressed uncertainty about their anonymity regarding their answers in the questionnaire. We found no real differences between ethnic Norwegian and immigrant women's attitudes toward and experiences with the tablet intervention. CONCLUSIONS Questions about IPV and a film about safety behaviors on a tablet, as a supplement to face-to-face communication, might initiate and facilitate communication about IPV in antenatal care. Uncertainty regarding anonymity has to be addressed when questions about IPV are being asked on a tablet. TRIAL REGISTRATION ClinicalTrials.gov NCT03397277; https://clinicaltrials.gov/ct2/show/NCT03397277.
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Affiliation(s)
- Bente Walter
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Hege Indreboe
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Mirjam Lukasse
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway.,Faculty of Health and Social Sciences, University of South-Eastern Norway, Vestfold, Norway
| | - Lena Henriksen
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
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Muldoon KA, Denize KM, Talarico R, Boisvert C, Frank O, Harvey ALJ, Rennicks White R, Fell DB, O'Hare-Gordon MA, Guo Y, Murphy MSQ, Corsi DJ, Sampsel K, Wen SW, Walker MC, El-Chaar D. COVID-19 and perinatal intimate partner violence: a cross-sectional survey of pregnant and postpartum individuals in the early stages of the COVID-19 pandemic. BMJ Open 2021; 11:e049295. [PMID: 34045216 PMCID: PMC8728372 DOI: 10.1136/bmjopen-2021-049295] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 03/13/2021] [Accepted: 04/08/2021] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE The objectives of this study were to: (1) document violent and controlling behaviours within intimate partnerships during the perinatal period; and (2) determine individual, interpersonal and household-level factors influencing the risk of perinatal intimate partner violence (IPV). DESIGN Cross-sectional survey. SETTING The Ottawa Hospital, Department of Obstetrics and Gynecology, Ottawa, Ontario, Canada. PARTICIPANTS Patients who gave birth at The Ottawa Hospital and were >20 days post partum between 17 March and 16 June 2020. MAIN OUTCOMES AND MEASURES Perinatal IPV was defined as regular controlling behaviours or act-based forms of emotional/physical/sexual abuse in the 12 months before pregnancy, during pregnancy and/or post partum. Log-binomial multivariable regression models were used to compute adjusted risk ratios (aRRs) and 95% CIs to identify potential risk factors for IPV: maternal age, postpartum depression, parity, increase in partner substance use and household income. RESULTS Among 216 participants, the median maternal age was 33 years (IQR: 30-36). In total, 52 (24.07%) reported some form of perinatal IPV, 37 (17.13%) reported regular controlling behaviour and 9 (4.17%) reported both. Household income below the municipal median was the strongest risk factor for perinatal IPV (aRR: 3.24, 95% CI: 1.87 to 5.59). There was no apparent association between maternal age (aRR: 0.99, 95% CI: 0.94 to 1.04), postpartum depression (aRR: 1.03, 95% CI: 1.00 to 1.07), nulliparity (aRR: 1.18, 95% CI: 0.71 to 1.97) or increases in partner substance use (aRR: 0.73, 95% CI: 0.42 to 1.25) with IPV. CONCLUSION One in four individuals in this study experienced perinatal IPV. Household income was the strongest risk factor, and surprisingly, many hypothesised risk factors (eg, mental health, partner substance use, etc) were not significantly associated with perinatal IPV in this sample. This highlights the challenges in both measuring IPV and identifying individuals exposed to perinatal IPV during the high stress of the COVID-19 pandemic.
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Affiliation(s)
- Katherine A Muldoon
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Obstetrics and Gynecology, University of Ottawa, Ottawa, Ontario, Canada
| | - Kathryn M Denize
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Robert Talarico
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Carlie Boisvert
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Olivia Frank
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Mailman School of Public Health, Columbia University, New York City, New York, USA
| | - Alysha L J Harvey
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Ruth Rennicks White
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Deshayne B Fell
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | | | - Yanfang Guo
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- BORN Ontario, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Malia S Q Murphy
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Daniel J Corsi
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Kari Sampsel
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Emergency Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Shi Wu Wen
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Mark C Walker
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Obstetrics and Gynecology, University of Ottawa, Ottawa, Ontario, Canada
| | - Darine El-Chaar
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
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Miller L, Contreras-Urbina M. Exploring the determinants and outcomes of intimate partner violence during pregnancy for Guyanese women: Results from a nationally representative cross-sectional household survey. Rev Panam Salud Publica 2021; 45:e6. [PMID: 33790954 PMCID: PMC7993238 DOI: 10.26633/rpsp.2021.6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 08/10/2020] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To determine predictors associated with physical violence during pregnancy, and to determine the relationship between exposure to intimate partner violence during pregnancy and women's health and suicide ideation in Guyana. METHODS A secondary data analysis of a cross-sectional household survey. Multivariate logistic regression models were fitted to the data to estimate the association between physical violence during pregnancy, controlling partner behavior, and other predictors. Ordered logistic regression models were fitted to estimate the association between physical violence during pregnancy and women's health, and lifetime physical partner violence and overall health. Logistic regression models were fitted to estimate associations between physical violence during pregnancy and lifetime physical partner violence and overall health and suicide ideation. RESULTS The prevalence of lifetime physical/sexual intimate partner violence was 38.8%, current physical/sexual intimate partner violence 11.1%, and violence during pregnancy 9.2%. Controlling partner behavior was significantly and positively associated with maternal experience of physical violence during pregnancy. Experiencing physical partner violence during pregnancy, but not lifetime physical partner violence, was associated with significantly increased odds of poor overall health. Physical violence during pregnancy and lifetime physical violence were both significantly associated with increased odds of suicide ideation. CONCLUSIONS The prevalence of violence during pregnancy in Guyana is high and is associated with adverse health outcomes. These findings suggest the need for intimate partner violence prevention, and for integrating intimate partner violence screening and treatment into antenatal care, reproductive health services, and maternal and child health programs and services to identify and treat at-risk women.
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Affiliation(s)
- Lior Miller
- George Washington UniversityWashington, D.C.United States of AmericaGeorge Washington University, Washington, D.C., United States of America.
| | - Manuel Contreras-Urbina
- The World BankWashington, D.C.United States of AmericaThe World Bank, Washington, D.C., United States of America.
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Román-Gálvez RM, Martín-Peláez S, Martínez-Galiano JM, Khan KS, Bueno-Cavanillas A. Prevalence of Intimate Partner Violence in Pregnancy: An Umbrella Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:E707. [PMID: 33467538 PMCID: PMC7830915 DOI: 10.3390/ijerph18020707] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 01/07/2021] [Accepted: 01/13/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Intimate partner violence (IPV) is a public health concern, especially during pregnancy, and needs to be urgently addressed. In order to establish effective actions for the prevention of IPV during pregnancy, authorities must be aware of the real burden of IPV. This review aimed to summarize the existing evidence about IPV prevalence during pregnancy worldwide. METHODS A review of reviews was carried out. All published systematic reviews and meta-analyses published until October 2020 were identified through PubMed, Scopus, and Web of Science. The main outcome was the IPV prevalence during pregnancy. RESULTS A total of 12 systematic reviews were included in the review, 5 of them including meta-analysis. The quality of the reviews was variable. Physical IPV during pregnancy showed a wide range (1.6-78%), as did psychological IPV (1.8-67.4%). CONCLUSIONS Available data about IPV prevalence during pregnancy were of low quality and showed high figures for physical and psychological IPV. The existing evidence syntheses do not capture the totality of the worldwide disease burden of IPV in pregnancy.
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Affiliation(s)
- Rosario M. Román-Gálvez
- Departamento de Enfermería, Facultad de Ciencias de la Salud, Universidad de Granada, 18071 Granada, Spain;
- Unidad Asistencial Churriana de la Vega, Servicio Andaluz de Salud, Churriana de la Vega, 18194 Granada, Spain
| | - Sandra Martín-Peláez
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad de Granada, 18071 Granada, Spain; (K.S.K.); (A.B.-C.)
- Instituto de Investigación Biosanitaria de Granada IBS, 18014 Granada, Spain
| | - Juan Miguel Martínez-Galiano
- Department of Nursing, University of Jaén, 23071 Jaén, Spain;
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
| | - Khalid Saeed Khan
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad de Granada, 18071 Granada, Spain; (K.S.K.); (A.B.-C.)
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
| | - Aurora Bueno-Cavanillas
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad de Granada, 18071 Granada, Spain; (K.S.K.); (A.B.-C.)
- Instituto de Investigación Biosanitaria de Granada IBS, 18014 Granada, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
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Vik ES, Aasheim V, Nilsen RM, Small R, Moster D, Schytt E. Paternal country of origin and adverse neonatal outcomes in births to foreign-born women in Norway: A population-based cohort study. PLoS Med 2020; 17:e1003395. [PMID: 33147226 PMCID: PMC7641355 DOI: 10.1371/journal.pmed.1003395] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 09/18/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Migration is a risk factor for adverse neonatal outcomes. The various impacts of maternal origin have been reported previously. The aim of this study was to investigate associations between paternal origin and adverse neonatal outcomes in births to migrant and Norwegian-born women in Norway. METHODS AND FINDINGS This nationwide population-based study included births to migrant (n = 240,759, mean age 29.6 years [±5.3 SD]) and Norwegian-born women (n = 1,232,327, mean age 29.0 years [±5.1 SD]) giving birth in Norway in 1990-2016. The main exposure was paternal origin (Norwegian-born, foreign-born, or unregistered). Neonatal outcomes were very preterm birth (22+0-31+6 gestational weeks), moderately preterm birth (32+0-36+6 gestational weeks), small for gestational age (SGA), low Apgar score (<7 at 5 minutes), and stillbirth. Associations were investigated in migrant and Norwegian-born women separately using multiple logistic regression and reported as adjusted odds ratios (aORs) with 95% confidence intervals (CIs), adjusted for year of birth, parity, maternal and paternal age, marital status, maternal education, and mother's gross income. In births to migrant women, a foreign-born father was associated with increased odds of very preterm birth (1.1% versus 0.9%, aOR 1.20; CI 1.08-1.33, p = 0.001), SGA (13.4% versus 9.5%, aOR 1.48; CI 1.43-1.53, p < 0.001), low Apgar score (1.7% versus 1.5%, aOR 1.14; CI 1.05-1.23, p = 0.001), and stillbirth (0.5% versus 0.3%, aOR 1.26; CI 1.08-1.48, p = 0.004) compared with a Norwegian-born father. In Norwegian-born women, a foreign-born father was associated with increased odds of SGA (9.3% versus 8.1%, aOR 1.13; CI 1.09-1.16, p < 0.001) and decreased odds of moderately preterm birth (4.3% versus 4.4%, aOR 0.95; CI 0.91-0.99, p = 0.015) when compared with a Norwegian-born father. In migrant women, unregistered paternal origin was associated with increased odds of very preterm birth (2.2% versus 0.9%, aOR 2.29; CI 1.97-2.66, p < 0.001), moderately preterm birth (5.6% versus 4.7%, aOR 1.15; CI 1.06-1.25, p = 0.001), SGA (13.0% versus 9.5%, aOR 1.50; CI 1.42-1.58, p < 0.001), low Apgar score (3.4% versus 1.5%, aOR 2.23; CI 1.99-2.50, p < 0.001), and stillbirth (1.5% versus 0.3%, aOR 4.87; CI 3.98-5.96, p < 0.001) compared with a Norwegian-born father. In Norwegian-born women, unregistered paternal origin was associated with increased odds of very preterm birth (4.6% versus 1.0%, aOR 4.39; CI 4.05-4.76, p < 0.001), moderately preterm birth (7.8% versus 4.4%, aOR 1.62; CI 1.53-1.71, p < 0.001), SGA (11.4% versus 8.1%, aOR 1.30; CI 1.24-1.36, p < 0.001), low Apgar score (4.6% versus 1.3%, aOR 3.51; CI 3.26-3.78, p < 0.001), and stillbirth (3.2% versus 0.4%, aOR 9.00; CI 8.15-9.93, p < 0.001) compared with births with a Norwegian-born father. The main limitations of this study were the restricted access to paternal demographics and inability to account for all lifestyle factors. CONCLUSION We found that a foreign-born father was associated with adverse neonatal outcomes among births to migrant women, but to a lesser degree among births to nonmigrant women, when compared with a Norwegian-born father. Unregistered paternal origin was associated with higher odds of adverse neonatal outcomes in births to both migrant and nonmigrant women when compared with Norwegian-born fathers. Increased attention to paternal origin may help identify women in maternity care at risk for adverse neonatal outcomes.
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Affiliation(s)
- Eline S. Vik
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Norway
- * E-mail:
| | - Vigdis Aasheim
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Norway
| | - Roy M. Nilsen
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Norway
| | - Rhonda Small
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
- Judith Lumley Centre, La Trobe University, Melbourne, Australia
| | - Dag Moster
- Department of Global Public Health and Primary Care, University of Bergen, Norway
- Department of Pediatrics, Haukeland University Hospital, Norway
| | - Erica Schytt
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Norway
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
- Centre for Clinical Research Dalarna, Uppsala University, Sweden
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Scharl AJ. Berlin, 31. Juli 2020 – Stellungnahme der Deutschen Gesellschaft für Gynäkologie und Geburtshilfe e. V. und der Deutschen Gesellschaft für Psychosomatische Frauenheilkunde und Geburtshilfe e. V. zu Gewalt gegen Frauen. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/a-1248-1316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Bovbjerg ML. Current Resources for Evidence-Based Practice, September 2020. J Obstet Gynecol Neonatal Nurs 2020; 49:487-499. [PMID: 32805207 PMCID: PMC7428455 DOI: 10.1016/j.jogn.2020.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
An extensive review of new resources to support the provision of evidence-based care for women and infants. The current column includes a discussion of “spin” in scientific reporting and its effect on summaries and syntheses of the literature and commentaries on reviews about early versus late amniotomy as part of labor induction protocols and the economic burden associated with maternal morbidity.
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Garnweidner-Holme L, Henriksen L, Flaathen EM, Klette Bøhler T, Lukasse M. Midwives' Attitudes Toward and Experience With a Tablet Intervention to Promote Safety Behaviors for Pregnant Women Reporting Intimate Partner Violence: Qualitative Study. JMIR Mhealth Uhealth 2020. [PMID: 32432553 DOI: 10.2196/168288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND Violence against women is considered a global health problem, and intimate partner violence (IPV) around the time of childbirth can have severe consequences for mother and child. Prenatal care is considered a window of opportunity to address IPV and ask women about exposure to violence since women are in regular contact with health care providers. Mobile health (mHealth) interventions might overcome the barriers to talking about IPV face-to-face. OBJECTIVE Our objective was to explore midwives' attitudes toward a tablet intervention consisting of information about IPV and safety behaviors as well as their experiences with recruiting pregnant women of different ethnic backgrounds in a randomized controlled trial (RCT). METHODS Individual interviews were conducted with 9 midwives who recruited participants for an RCT to test a video to promote safety behaviors delivered on a tablet during prenatal care. Analysis was guided by thematic analysis. RESULTS Midwives perceived the tablet intervention as an appropriate supplement during prenatal care to provide information about IPV and promote safety behaviors. They participated in the RCT primarily to obtain more knowledge regarding how to communicate about IPV. The intervention was perceived as an anonymous door-opener to talk about IPV and a good solution to ensure that every woman gets the same information. However, the content of the intervention had to be trustworthy and align with the information the midwives provide to women. Given the sensitivity of IPV, midwives outlined the importance of following the intervention with face-to-face communication. Midwives reported technical problems and a high demand on their time as the main challenges to recruiting women. They experienced challenges recruiting women of different ethnic backgrounds due to linguistic barriers and the women's skepticism about scientific research. CONCLUSIONS The tablet intervention might help midwives communicate about IPV. Although the video was considered as an anonymous door-opener to talk about IPV, midwives outlined the importance of following the intervention with face-to-face communication. The scarcity of midwives' time during consultations has to be considered when implementing the intervention. Further research is needed to overcome barriers that limit inclusion of women from different ethnic backgrounds. TRIAL REGISTRATION ClinicalTrials.gov NCT03397277; https://clinicaltrials.gov/ct2/show/NCT03397277.
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Affiliation(s)
- Lisa Garnweidner-Holme
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Lena Henriksen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Eva Marie Flaathen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Tone Klette Bøhler
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Mirjam Lukasse
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- Faculty of Health and Social Sciences, University of South-Eastern Norway, Campus Vestfold, Borre, Norway
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Garnweidner-Holme L, Henriksen L, Flaathen EM, Klette Bøhler T, Lukasse M. Midwives' Attitudes Toward and Experience With a Tablet Intervention to Promote Safety Behaviors for Pregnant Women Reporting Intimate Partner Violence: Qualitative Study. JMIR Mhealth Uhealth 2020; 8:e16828. [PMID: 32432553 PMCID: PMC7270855 DOI: 10.2196/16828] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 03/13/2020] [Accepted: 03/20/2020] [Indexed: 01/28/2023] Open
Abstract
Background Violence against women is considered a global health problem, and intimate partner violence (IPV) around the time of childbirth can have severe consequences for mother and child. Prenatal care is considered a window of opportunity to address IPV and ask women about exposure to violence since women are in regular contact with health care providers. Mobile health (mHealth) interventions might overcome the barriers to talking about IPV face-to-face. Objective Our objective was to explore midwives’ attitudes toward a tablet intervention consisting of information about IPV and safety behaviors as well as their experiences with recruiting pregnant women of different ethnic backgrounds in a randomized controlled trial (RCT). Methods Individual interviews were conducted with 9 midwives who recruited participants for an RCT to test a video to promote safety behaviors delivered on a tablet during prenatal care. Analysis was guided by thematic analysis. Results Midwives perceived the tablet intervention as an appropriate supplement during prenatal care to provide information about IPV and promote safety behaviors. They participated in the RCT primarily to obtain more knowledge regarding how to communicate about IPV. The intervention was perceived as an anonymous door-opener to talk about IPV and a good solution to ensure that every woman gets the same information. However, the content of the intervention had to be trustworthy and align with the information the midwives provide to women. Given the sensitivity of IPV, midwives outlined the importance of following the intervention with face-to-face communication. Midwives reported technical problems and a high demand on their time as the main challenges to recruiting women. They experienced challenges recruiting women of different ethnic backgrounds due to linguistic barriers and the women’s skepticism about scientific research. Conclusions The tablet intervention might help midwives communicate about IPV. Although the video was considered as an anonymous door-opener to talk about IPV, midwives outlined the importance of following the intervention with face-to-face communication. The scarcity of midwives’ time during consultations has to be considered when implementing the intervention. Further research is needed to overcome barriers that limit inclusion of women from different ethnic backgrounds. Trial Registration ClinicalTrials.gov NCT03397277; https://clinicaltrials.gov/ct2/show/NCT03397277
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Affiliation(s)
- Lisa Garnweidner-Holme
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Lena Henriksen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Eva Marie Flaathen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Tone Klette Bøhler
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Mirjam Lukasse
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.,Faculty of Health and Social Sciences, University of South-Eastern Norway, Campus Vestfold, Borre, Norway
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