Physical abuse during pregnancy and risk of low-birthweight infants among aborigines in Taiwan

Domestic violence against pregnant women is a potential risk factor for low birthweight in full-term neonates: A population-based retrospective cohort study

Domestic violence's most frequently reported outcomes are preterm delivery and low birthweight, both of which are the strongest correlates of mortality and morbidity. Several studies have shown that pregnant women with domestic violence during pregnancy were more likely to deliver low-birthweight and preterm neonates. However, there has been no consensus on associations between domestic violence and low-birthweight and preterm delivery. To examine the impact of domestic violence on birthweight stratified by preterm or full-term delivery, a population-based retrospective cohort study was conducted that linked four national databases in Taiwan. A total of 1,322 subjects associated with a report of domestic violence during pregnancy were compared with 485,981 subjects without any record of reported domestic violence. The percentage of low birthweight in the group exposed to domestic violence was significantly higher than in the unexposed group with full-term delivery (4.9% vs. 3.3%, p = 0.001). Multivariable logistic regression analysis showed that pregnant women exposed to domestic violence had an OR of 1.37 (95% CI 1.05, 1.79) for low birthweight in full-term delivery. However, domestic violence was not significantly associated with low birthweight in preterm delivery. Screening for intimate partner violence in the perinatal health care system should be seen as especially important for women who have had full-term low-birthweight neonates.

Nursing research on intimate partner violence in China: A scoping review

Intimate partner violence (IPV) is a serious public health issue, and nurses have the potential to screen, navigate to interventions, and provide support, but responses to IPV differ greatly in mainland China, Hong Kong, Macao, and Taiwan. We conducted a scoping review to examine the nursing literature on IPV in the above four regions in China. We conducted a comprehensive search of 11 Chinese and English databases from database inception to January 31, 2020, for eligible papers including empirical studies, reviews, reports, and expert opinion articles. We hand searched references lists and other studies published by the first and corresponding authors of included articles. Two reviewers independently screened articles and extracted data, and three reviewers cross-checked the extracted results. We also conducted quality appraisal for applicable empirical studies. A total of 58 Chinese-language and 63 English-language articles were included, 58 from Taiwan, 44 from Hong Kong, 13 from mainland China, and six from institutions outside China, but none from Macao. The quantitative and qualitative studies described the prevalence and complex nature of IPV, comparable to non-nursing and international studies. Nurse-led advocacy and Qigong (traditional Chinese mind-body health practice) interventions showed promise for improving mental health in women in Hong Kong. There was a low level of knowledge and preparedness to respond to IPV among Chinese nurses, especially in mainland China. Mixed methods studies in Hong Kong and Taiwan as complex designs were generally well-conducted. Nursing case reports from Taiwan uniquely supplemented the evidence base. In Hong Kong and Taiwan, varying designs were used to study various facets of IPV, targeting victims, nurses and other key stakeholders. In mainland China and Macao, IPV research was limited in quantity, quality, and diversity. As more research in the area of IPV is needed, factors influencing nursing research on IPV also merit investigation, while taking into consideration socio-economic-political-cultural factors.

Factors Associated with Low Birth Weight in Indigenous Populations: a systematic review of the world literature

Abstract Objectives: we aimed to identify etiological factors for low birth weight (LBW), prematurity and intrauterine growth restriction (IUGR) in the Indigenous Population. Methods: for this systematic review, publications were searched in Medline/PubMed, Scopus, Web of Science, and Lilacs until April 2018. The description in this review was based on the PRISMA guideline (Study protocol CRD42016051145, registered in the Centre for Reviews and Dissemination at University of York). We included original studies that reported any risk factor for one of the outcomes in the Indigenous Population. Two of the authors searched independently for papers and the disagreements were solved by a third reviewer Results: twenty-four studies were identified, most of them were from the USA, Canada and Australia. The factors associated were similar to the ones observed in the non-indigenous including unfavorable obstetric conditions, maternal malnutrition, smoking, and maternal age at the extremes of childbearing age, besides environmental factors, geographic location, and access to health care in indigenous communities. Conclusions: etiologic factors for LBW in Indigenous Population have been receiving little attention, especially in Latin America. The three outcomes showed common causes related to poverty and limited access to healthcare. New studies should ensure explicit criteria for ethnicity, quality on the information about gestational age, and the investigation on contextual and culture-specific variables.

Intimate partner violence victimization increases the risk of under-five morbidity: A stratified multilevel analysis of pooled Tanzania Demographic Health Surveys, 2010-2016

INTRODUCTION

A hidden determinant such as intimate partner violence victimization has been associated with under-five morbidity and mortality. However, there is lack of information regarding which exactly age group of under-five is more vulnerable to morbidity when their mothers exposed to intimate partner violence victimization. This study aimed to determine the effect of mothers' exposure to intimate partner violence victimization on age groups specific under-five morbidity that could lead to mortality.

MATERIAL AND METHODS

The current study pooled and analyzed data from 2010 and 2016 Tanzania Demographic Health Survey datasets. We used a stratified multilevel modeling to assess the association between under-five morbidity and intimate partner violence victimization according to age groups. The Statistical approach using Stata 14 was used to adjust for clustering effect and weighted the estimates to correct for non-responses and disproportionate sampling employed during designing of the surveys.

RESULTS

A total of 13,639 singleton live-births babies within three years prior to interview dates from the ever-married women were included in the analysis. We found a significant reduction of the three main symptoms of under-five morbidity namely; a cough with difficult or fast breathing from 21.7 to 15.7%, fever from 22.5 to 18.3%, and diarrhoea from 15.5 to 12.7% for the survey years from 2010 to 2016 respectively (P<0.05). Overall, about 40% of mothers reported experiencing any forms of intimate partner violence victimization. After adjusting for individual and cluster variables, we found that under-five in post-neonatal period (Adjusted odds ratios = 1.50; 95%CI, 1.21-1.86) and childhood period (Adjusted odds ratios = 1.40; 95%CI, 1.24-1.57) were significantly affected with morbidity when their mothers' exposed to any form of intimate partner violence victimization.

CONCLUSION

This analysis revealed that intimate partner violence victimization is still a major and public health problem in Tanzania that threatens child health during the period of post-neonatal and childhood. There is a need to introduce screening for intimate partner violence victimization in maternal and child care for effective monitoring and prevention of the problem.

The Impact of Intimate Male Partner Violence on Women's Sexual Function: A Study in Iran

INTRODUCTION

Sexuality is an integral part of a woman's life. A variety of factors can affect a woman's sexuality, among them physical disorders, social-religious beliefs, age, psychological factors, depression, mental tension, disbelief, an unfulfilling relationship with one's spouse and emotional and physical violence.

AIM

The present study aimed to explore the rate of domestic violence against women and its impact on women's sexuality.

MATERIALS AND METHODS

This cross-sectional study was conducted on 813 women referring to the gynaecology clinics of Jahrom, Iran, from April to October 2015. Data were collected using a demographics questionnaire, a violence questionnaire and Female Sexual Function Index (FSFI). The collected data were analysed using Student's t-test and logistic regression.

RESULTS

The prevalence of violence was found to be 43.2%. Also, there was a significant relationship between violence and age (OR=1.33 95% CI=2.22-7.95, p<0.001). The rate of violence was found to increase by 3.1 times with an increase in the length of marriage (OR=3.1595% CI=1.42-4.12, p<0.001). Moreover, domestic violence significantly correlated with women's education level (OR=11.75 95% CI=2.15-64.12, p=0.002) and their husband's education level (OR=0.194, 95%CI=0.329-0.919, p=0.02). The results showed that the sexual function mean score of non-abused women and abused women were 17.74±8.82 and 14.59±10.63, respectively. However, a significant difference was found between the two groups regarding the domains of sexual function (p<0.05).

CONCLUSION

This study showed that the frequency of domestic violence is rather high and that can increase the risk of sexual dysfunction. Thus, routine screening for violence and sexual dysfunction is recommended for early detection of violence and sexual dysfunction.

Physical intimate partner violence and low birth weight in newborns from primary health care units of the city of Rio de Janeiro

ABSTRACT Objective To investigate the association between physical intimate partner violence and low birth weight. Methods This cross-sectional study included 604 children with approximately 30 days of age who visited four primary health care units in the city of Rio de Janeiro , Brazil, for the second dose of hepatitis B vaccine. Children with a birth weight below 2.500 g were considered underweight. Information regarding physical intimate partner violence was obtained by the Portuguese version of the Conflict Tactics Scale. The study investigated the 12 months prior to interview. Physical intimate partner violence was analyzed as a dichotomous variable and cumulatively. Associations between physical intimate partner violence and low birth weight were verified by logistic regression models based on crude and adjusted odds ratios and their respective 95% confidence intervals. Results Some (7.1%) babies were born underweight, and 33.6% of the mothers had been exposed to physical intimate partner violence. Physical intimate partner violence was significantly associated with low birth weight (OR=3.69; 95%CI=1.57-8.66). Notably, the odds of low birth weight increase with the severity of violence. Conclusion These findings draw attention to the consequences of physical intimate partner violence on the nutritional status of newborns and emphasize the need of greater attention during prenatal care to improve women's quality of life and to reduce the rate of low birth weight.

Prevalence and Risk Factors of Domestic Violence Against Women by Their Husbands in Iran

OBJECTIVE

Domestic violence against women is a health problem. Research on domestic violence in order to clarify the relationship between the different forms of violence and health outcomes is needed. This study aimed to determine the frequency and risk factors of domestic violence in women. It also assessed the association between risk factors and psychological, physical, and sexual violence against women by their intimate partners.

MATERIALS & METHODS

This cross-sectional study was done on married women 16-80 years of age living in jahrom south of Iran between August 2013 and December 2014. This research was implemented through questionnaires including the demographic characteristic. The form of partner violence including emotional abuse, physical violence and sexual violence was assessed with a validated questionnaire. Odds ratios and 95% confidence intervals were calculated to measure the association between violence and factors.

RESULTS

The prevalence of physical, sexual and emotional domestic violence was respectively 16.4%, 18.6% and 44.4%.and was associated with Age (p=0.002), Husband's Age (p=0.001), Length of marriage (p=0.002), Woman's low educational level women's education (OR=4.67 95%.CI=1.97-11.07), husband's low education (OR=9.22 95%. CI=0.69-12.16), were the most important risk factors for violence.

CONCLUSION

Prevalence of physical, emotional or sexual violence was very high. Men's violence against women in intimate relationships is commonly occurring in Iran. Considering the factors contributing to violence against women, raising the level of education of men and women is one of the ways to prevent violence.

Trauma in pregnancy: an updated systematic review

We reviewed recent data on the prevalence, risk factors, complications, and management of trauma during pregnancy. Using the terms "trauma" and "pregnancy" along with specified mechanisms of injury, we queried the PubMed database for studies reported from Jan. 1, 1990, through May 1, 2012. Studies with the largest number of patients for a given injury type and that were population-based and/or prospective were included. Case reports and case series were used only when more robust studies were lacking. A total of 1164 abstracts were reviewed and 225 met criteria for inclusion. Domestic violence/intimate partner violence and motor vehicle crashes are the predominant causes of reported trauma during pregnancy. Management of trauma during pregnancy is dictated by its severity and should be initially geared toward maternal stabilization. Minor trauma can often be safely evaluated with simple diagnostic modalities. Pregnancy should not lead to underdiagnosis or undertreatment of trauma due to unfounded fears of fetal effects. More studies are required to elucidate the safest and most cost-effective strategies for the management of trauma in pregnancy.

Alcohol consumption after the recognition of pregnancy and correlated factors among indigenous pregnant women in Taiwan

To examine the rates and factors associated with alcohol consumption after the recognition of pregnancy among indigenous pregnant women, as well as the rates and factors associated with continuing alcohol consumption after the recognition of pregnancy among indigenous pregnant women who drank alcohol before the recognition of pregnancy in 10 hospitals in southern and eastern Taiwan. A total of 806 indigenous women who had just given birth in 10 hospitals in southern and eastern Taiwan were recruited. They were interviewed to collect their substance use information, demographic characteristics, psychological health status, history of physical abuse, and pregnancy history. The rates of alcohol consumption after the recognition of pregnancy in all indigenous pregnant women and the rates of continuing alcohol consumption after the recognition of pregnancy among those who drank alcohol before the recognition of pregnancy were calculated. The factors relating to alcohol consumption and continuing alcohol consumption after the recognition of pregnancy were examined using logistic regression analyses. The results of this study found that 26.6% of indigenous pregnant women drank alcohol at any stage after the recognition of pregnancy, and 52.5% of indigenous pregnant women who drank alcohol before the recognition of pregnancy persisted in drinking alcohol after the recognition of pregnancy. Multiple parities, smoking or chewing betel quid after the recognition of pregnancy, and a higher frequency of drinking alcohol before the recognition of pregnancy were significantly associated with alcohol consumption and continuing alcohol consumption after the recognition of pregnancy. Meanwhile, being single or divorced, and intimate partner violence after the recognition of pregnancy were significantly associated with alcohol consumption after the recognition of pregnancy. High prevalence rates of alcohol consumption and continuing alcohol consumption after the recognition of pregnancy were found among indigenous pregnant women in Taiwan. Early detection of alcohol consumption and effective intervention for alcohol consumption during pregnancy are needed.

The use of psychosocial stress scales in preterm birth research

Psychosocial stress has been identified as a potential risk factor for preterm birth. However, an association has not been found consistently, and a consensus on the extent to which stress and preterm birth are linked is still lacking. A literature search was performed with a combination of keywords and MeSH terms to detect studies of psychosocial stress and preterm birth. Studies were included in the review if psychosocial stress was measured with a standardized, validated instrument and if the outcomes included either preterm birth or low birthweight. Within the 138 studies that met inclusion criteria, 85 different instruments were used. Measures that had been designed specifically for pregnancy were used infrequently, although scales were sometimes modified for the pregnant population. The many different measures that have been used may be a factor that accounts for the inconsistent associations that have been observed.

Maternal and foetal outcomes among pregnant women hospitalised due to interpersonal violence: a population based study in Western Australia, 2002-2008

Background

Interpersonal violence is responsible for more ill-health and premature death in women under the age of 45 than other preventable health conditions, but findings concerning the effects of violence during pregnancy on both maternal and foetal health have been inconsistent.

Methods

A retrospective population-based cohort study was undertaken using linked data from the Hospital Morbidity Data Collection and the Western Australian Midwives' Notification System from 2002 to 2008. The aim was to determine the association between exposure to interpersonal violence during pregnancy and adverse maternal and foetal health outcomes at the population level.

Results

A total of 468 pregnant women were hospitalised for an incident of interpersonal violence during the study period, and 3,744 randomly selected pregnant women were included as the comparison group. The majority of violent events were perpetrated by the pregnant women's partner or spouse. Pregnant Indigenous women were over-represented accounting for 67% of all hospitalisations due to violence and their risk of experiencing adverse maternal outcomes was significantly increased compared to non-Indigenous women (adjusted odds ratio 1.53, 95% CI 1.21 to 1.95, p = 0.01). Pregnant women hospitalised for an incident of interpersonal violence sustained almost double the risk for adverse maternal complications than the non-exposed group (95% CI 1.34 to 2.18, p < 0.001). The overall risk for adverse foetal complications for pregnant women exposed to violence was increased two-fold (95% CI 1.50 to 2.76, p < 0.001).

Conclusions

The risk of adverse health outcomes for both the mother and the baby increases if a pregnant woman is hospitalised for an incident of interpersonal violence during pregnancy.

Impacts of domestic violence on child growth and nutrition: a conceptual review of the pathways of influence

Domestic violence against women is a global problem, and young children are disproportionate witnesses. Children's exposure to domestic violence (CEDV) predicts poorer health and development, but its effects on nutrition and growth are understudied. We propose a conceptual framework for the pathways by which domestic violence against mothers may impair child growth and nutrition, prenatally and during the first 36 months of life. We synthesize literatures from multiple disciplines and critically review the evidence for each pathway. Our review exposes gaps in knowledge and opportunities for research. The framework also identifies interim strategies to mitigate the effects of CEDV on child growth and nutrition. Given the global burden of child malnutrition and its long-term effects on human-capital formation, improving child growth and nutrition may be another reason to prevent domestic violence and its cascading after-effects.

Maternal exposure to domestic violence and pregnancy and birth outcomes: a systematic review and meta-analyses

BACKGROUND

Pregnant women who experience domestic violence are at increased risk of adverse outcomes in addition to the risks to themselves. Inadequate prenatal care, higher incidences of high-risk behaviors, direct physical trauma, stress, and neglect are postulated mechanisms. Our objective was to systematically review birth outcomes among women who experienced domestic violence.

METHODS

Medline, Embase, CINAHL, and bibliographies of identified articles were searched for English language studies. Studies reporting rates of low birth weight, preterm birth, small for gestational age births, birth weight, or gestational age at birth were included. Study quality was assessed for selection, exposure assessment, confounder adjustment, analyses, outcomes assessment, and attrition biases. Unadjusted and adjusted data from included studies were extracted by two reviewers. Summary odds ratio (OR) and confidence intervals (CI) were calculated using the random effects model. Population-attributable risk was calculated.

RESULTS

Thirty studies of low to moderate risk of biases were included. Low birth weight (adjusted OR 1.53, 95% CI 1.28-1.82) and preterm births (adjusted OR 1.46, 95% CI 1.27-1.67) were increased among women exposed to domestic violence. As the prevalence of reported domestic violence during pregnancy was low, the population-attributable risk was low. Prospective cohort studies provided robust and consistent results.

CONCLUSIONS

Maternal exposure to domestic violence was associated with significantly increased risk of low birth weight and preterm birth. Underreporting of domestic violence is hypothesized. Effective programs to identify violence and intervene during pregnancy are essential.

Revision of the Abuse Assessment Screen to address nonlethal strangulation

The Abuse Assessment Screen has been used since 1987 to identify and assess for intimate partner violence in a wide variety of clinical and research settings. It has been translated and successfully used in at least 7 languages in addition to English. Meanwhile, a growing body of research indicates that nonlethal strangulation (commonly called "choking") is a significant form of intimate partner violence and that choking has substantial consequences for the health of the woman. This paper describes the modification of the Abuse Assessment Screen to include "choking."

Intimate partner and nonpartner violence against pregnant women in rural Haiti

OBJECTIVE

To examine the association between violence experienced by pregnant Haitian women in the previous 6 months and pregnancy-related symptom distress.

METHODS

A total of 200 women seeking prenatal care at community health dispensaries in the Artibonite Valley were interviewed.

RESULTS

Over 4 in 10 women (44.0%) reported that they had experienced violence in the 6 months prior to interview; 77.8% of these women reported that the violence was perpetrated by an intimate partner. Those who experienced intimate partner violence reported significantly greater pregnancy-related symptom distress (beta=0.23, P=0.001). No significant differences between violence perpetrated by family members or others and reporting of symptoms were observed (beta=0.06, P=0.38).

CONCLUSION

The findings indicate the need to integrate violence screening, resources, and primary prevention into prenatal care in rural Haiti.

Intimate Partner Violence: A Clinical Review of Screening and Intervention

One in four American women will be physically assaulted or raped by an intimate partner during her lifetime. Such exposure has wide-ranging health effects. Abused women have an increased risk of cardiac, gastrointestinal, gynecologic, musculoskeletal, neurologic and psychological complaints. They also have a greater utilization of medical services and are more likely to access outpatient primary care and specialty care, emergency departments and mental health and substance abuse services than women without a history of partner violence. Most major US medical organizations recommend routine screening of all women for partner abuse. Offering abused women empathy and validation along with referral to local resources is encouraged. Physicians should also document the abuse in the victim's medical record.