Mother-newborn health indicators in possible victims of gender-based violence during pregnancy

Intimate partner violence and perinatal health: a systematic review

BACKGROUND

Physical, psychological and sexual intimate partner violence (IPV) has been described in the literature as different types of IPV experienced by women during pregnancy all over the world.

OBJECTIVES

To review and summarise systematically the empirical evidence on the links between IPV during pregnancy and the perinatal health of mothers and fetuses/neonates.

SEARCH STRATEGY

MEDLINE (Ovid), CINAHL, Embase, Nursing@ovid (Ovid) and LILACS were searched (2008-2018).

SELECTION CRITERIA

Observational studies that examined perinatal health outcomes (i.e. pre-term birth, low birthweight, miscarriage, perinatal death and premature rupture of membranes) in pregnant women exposed to IPV.

DATA COLLECTION AND ANALYSIS

Information on study characteristics, type of IPV measured, study design, methodological quality and outcome variable extracted.

RESULTS

Fifty studies were included. Twenty-nine analysed undifferentiated IPV (n = 25 489), 34 included physical IPV (n = 7333), 22 analysed psychological IPV (n = 7833) and 18 examined sexual IPV (n = 2388). Fifteen studies were from Asia, 12 from North America and Oceania, and 12 from Central and South America. The studies examined the association between IPV and 39 different perinatal health outcomes. The most frequent outcomes reported were pre-term birth (50%), low birthweight (46%), miscarriage (30%), perinatal death (20%) and premature rupture of membranes (20%). A significant association with perinatal health outcomes was reported by 12 of the studies analysing undifferentiated IPV, 18 physical IPV, six psychological IPV and two sexual IPV.

CONCLUSIONS

The relation between IPV and perinatal health outcomes can be seen in different epidemiological designs and countries. In all, 39 different outcomes were identified and 29 were associated with IPV.

TWEETABLE ABSTRACT

A variety of poor perinatal health outcomes are associated with psychological, physical and sexual IPV.

Intimate Partner Violence and Breastfeeding Outcomes in a Sample of Low-Income Women

BACKGROUND

Intimate partner violence has been related to breastfeeding difficulties. Few studies, however, have also accounted for other biopsychosocial risk factors associated with women's breastfeeding. Research aim: This study aimed to examine how prenatal intimate partner violence affects women's breastfeeding initiation, early cessation, and exclusivity at 6 weeks postpartum, controlling for perinatal health problems, prenatal depression, childhood adverse experiences, and prenatal breastfeeding education.

METHODS

A longitudinal, prospective one-group study was conducted. Data were collected via interview and survey from a sample of low-income pregnant women ( N = 101) during pregnancy and at 6 weeks postpartum. The Pregnancy Risk Assessment Monitoring System was used to assess breastfeeding behaviors, prenatal breastfeeding education, and perinatal health problems. Intimate partner violence was assessed using the Conflict Tactics Scales-Revised; adverse childhood experiences and depression were assessed using the Adverse Childhood Experiences and Center for Epidemiologic Studies Depression Scale, respectively.

RESULTS

Women's breastfeeding initiation was predicted by prenatal breastfeeding education (adjusted odds ratio [ OR] = 3.21, p < .05). Early breastfeeding cessation was predicted by prenatal exposure to intimate partner violence (adjusted OR = 0.22, p < .05), preterm labor (adjusted OR = 0.33, p < .05), and prenatal breastfeeding education (adjusted OR = 1.80, p < .05).

CONCLUSION

These findings highlight the importance of addressing biopsychosocial risk factors, particularly adversity and perinatal health, in efforts to promote women's breastfeeding success. Future research should evaluate mechanisms that may explain the link between intimate partner violence and breastfeeding cessation.