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Naseem H, Park S, Rowther AA, Atif N, Rahman A, Perin J, Zaidi A, Malik A, Surkan PJ. Perinatal Intimate Partner Violence and Maternal-Infant Bonding in Women With Anxiety Symptoms in Pakistan: The Moderating Role of Breastfeeding. JOURNAL OF INTERPERSONAL VIOLENCE 2024:8862605241271364. [PMID: 39189042 DOI: 10.1177/08862605241271364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/28/2024]
Abstract
Intimate partner violence (IPV) during the perinatal period can negatively affect both a woman's health and the bonding with her infant. Research on IPV among pregnant women experiencing psychological distress in South Asia is limited. We examined associations between perinatal exposure to IPV and postnatal maternal-infant bonding in Pakistani women with symptoms of anxiety and assessed if breastfeeding practices moderated these associations. Postnatal data were collected from 720 Pakistani women who reported at least mild levels of anxiety symptoms in pregnancy. We performed Poisson regression with robust variance analyses to examine the associations between IPV during pregnancy or within 6 weeks after delivery (i.e., the perinatal period) and maternal-infant bonding. Interaction terms between IPV and breastfeeding practices were included in the analytic models to examine the moderating effects. About 27% of women were exposed to at least one type of perinatal IPV. Women who were exposed to IPV were more likely to have moderate to severe postpartum anxiety (n = 57, 28.9% of IPV-exposed women), compared to those without IPV (n = 65, 12.4% of unexposed women; p value < .001). Compared to women not reporting IPV, women exposed to any IPV showed a 38% increase in Postpartum Bonding Questionnaire scores, suggesting higher likelihood of impaired bonding (risk ratio [RR] = 1.38, 95% confidence interval [CI] [1.21, 1.56]). Among women who initiated breastfeeding later than 1 hr post-delivery, IPV was associated with impaired bonding (RR = 1.09, 95% CI [1.06, 1.20]), whereas no association was present for women who initiated breastfeeding within 1 hr (RR = 1.03, 95% CI [0.98, 1.08]). In addition to the efforts to reduce IPV, encouraging IPV-exposed women to adhere to the breastfeeding guidelines (e.g., early breastfeeding) may enhance maternal-infant bonding.
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Affiliation(s)
- Hina Naseem
- Human Development Research Foundation, Rawalpindi, Pakistan
| | - Soim Park
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Najia Atif
- Human Development Research Foundation, Rawalpindi, Pakistan
| | | | - Jamie Perin
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ahmed Zaidi
- Human Development Research Foundation, Rawalpindi, Pakistan
| | - Abid Malik
- Human Development Research Foundation, Rawalpindi, Pakistan
- Health Services Academy, Islamabad, Pakistan
| | - Pamela J Surkan
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Doerzbacher M, Sperlich M, Hequembourg A, Chang YP. A Longitudinal Qualitative Study of Barriers and Facilitators of Breastfeeding in Women on Opioid Maintenance Therapy. J Perinat Neonatal Nurs 2024; 38:306-314. [PMID: 39074327 DOI: 10.1097/jpn.0000000000000847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/31/2024]
Abstract
PURPOSE To understand how barriers and facilitators interact over time to support or disrupt breastfeeding among women on opioid maintenance therapy for opioid use disorder. BACKGROUND Breastfeeding has additional benefits for newborns with prenatal opioid exposure. Up to 80% of women on opioid maintenance therapy plan to breastfeed, but many do not beyond the first 7 to 10 days. METHODS A qualitative, longitudinal design was used. Semi-structured interviews occurred during the third trimester of pregnancy and again between 1 and 6 weeks postpartum. Thematic analysis was conducted using the Breastfeeding in a Life Course Context model as a framework. The design and methods were informed by a post-positivist, critical realist perspective. RESULTS Thirteen participants were enrolled, and 19 interviews were completed. Five themes were identified. It Will Work Out was the primary theme that describes participants' sense of self-efficacy, stemming from their experiences of managing addiction recovery. Women considered breastfeeding to support their own health and that of their newborn while in recovery, summarized by Being Healthy. Making the choice to breastfeed, represented by Weighing the Options, was influenced by their perinatal health care providers. During the Sensitive Period, challenges could overwhelm their self-efficacy. Of 9 women, 4 were still breastfeeding when interviewed postpartum, exemplified by Moving On. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Participants' self-efficacy and motivation to be healthy played a significant role in managing breastfeeding challenges over time. Nursing interventions must empower women's self-efficacy to help them achieve their breastfeeding goals.
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Affiliation(s)
- Margaret Doerzbacher
- University at Buffalo School of Nursing, Buffalo, New York (Drs Doerzbacher, Hequembourg, and Chang); and University at Buffalo School of Social Work, Buffalo, New York (Dr Sperlich)
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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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Finnbogadóttir HR, Henriksen L, Hegaard HK, Halldórsdóttir S, Paavilainen E, Lukasse M, Broberg L. The Consequences of A History of Violence on Women's Pregnancy and Childbirth in the Nordic Countries: A Scoping Review. TRAUMA, VIOLENCE & ABUSE 2024:15248380241253044. [PMID: 38805432 DOI: 10.1177/15248380241253044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2024]
Abstract
Violence against women (VAW) is a global challenge also in the childbearing period. Despite high gender equality, there is a high prevalence of VAW in the Nordic countries. This scoping review aims to explore predictors for and consequences of a history of violence on women's pregnancy and childbirth in the Nordic countries, including women's experience of the impact of violence and the interventions used to detect, address consequences, and prevent further violence. The framework by Arksey and O'Malley was followed, and English, Finnish, Icelandic, Norwegian, Danish, and Swedish literature was included. The population was women aged ≥18 residing in the Nordic countries during the perinatal period. Eight databases were searched: MEDLINE, CINAHL, PubMed, PsycINFO, Web of Science, ASSIA, Social Services-, and Sociological abstracts. There was no limitation of the search time frame. The initial screening resulted in 1,104 records, and after removing duplicates, 452 remained. Finally, 61 papers met the inclusion criteria. The results covering the past 32 years indicated that childbearing women with a history of violence are at greater risk of common complaints and hospitalization during pregnancy, fear of childbirth, Cesarean section, breastfeeding difficulties, and physical and mental health problems. While extensive research was found on the associations between a history of and current violence and outcomes related to pregnancy, there was a lack of intervention studies and studies from Finland. Efforts must be made to scientifically test the methods used to reduce and treat the adverse effects of a history of violence and prevent further violence.
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Affiliation(s)
| | | | - Hanne Kristine Hegaard
- Copenhagen University Hospital-Rigshospitalet, Denmark
- The University of Copenhagen, Denmark
| | | | | | | | - Lotte Broberg
- Bispebjerg and Frederiksberg Hospital, Denmark
- Slagelse Hospital, Denmark
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Stockman D, Haney L, Uzieblo K, Littleton H, Keygnaert I, Lemmens G, Verhofstadt L. An ecological approach to understanding the impact of sexual violence: a systematic meta-review. Front Psychol 2023; 14:1032408. [PMID: 37292501 PMCID: PMC10244654 DOI: 10.3389/fpsyg.2023.1032408] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 05/08/2023] [Indexed: 06/10/2023] Open
Abstract
Aim A systematic meta-review was conducted to examine (1) the broad range of negative and positive individual and interpersonal changes following adult sexual violence, as well as (2) the risk/protective factors at multiple levels of the social ecology (e.g., individual, assault, and micro/meso/exo/macro/chronosystem factors)-influencing the impact of sexual violence. Methods Searches of Web of Science, Pubmed, and ProQuest resulted in inclusion of 46 systematic reviews or meta-analyses. Review findings were extracted for summary and a deductive thematic analysis was conducted. Results Experiencing sexual violence is associated with many negative individual and sexual difficulties as well as revictimization risk. Only a limited number of reviews reported on interpersonal and positive changes. Factors at multiple levels of the social ecology play a role in the intensity of these changes. Reviews including macrolevel factors were non-existent, however. Conclusion Reviews on sexual violence are fragmented in nature. Although the use of an ecological approach is often lacking, adopting such a perspective in research is necessary for a fuller understanding of the multiple influences on survivor outcomes. Future research should evaluate the occurrence of social and positive changes following sexual violence, as well as the role of macrolevel factors in influencing post-assault outcomes.
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Affiliation(s)
- Dagmar Stockman
- Department of Experimental Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | - Laura Haney
- Department of Psychology, East Carolina University, Greenville, NC, United States
| | - Kasia Uzieblo
- Department of Criminology, Vrije Universiteit Brussel, Brussel, Belgium
- Forensic Care Specialists, Van der Hoeven Clinic, Utrecht, Netherlands
| | - Heather Littleton
- Lyda Hill Institute for Human Resilience, University of Colorado Colorado Springs, Colorado Springs, CO, United States
| | - Ines Keygnaert
- International Centre for Reproductive Health, Ghent University, Ghent, Belgium
| | - Gilbert Lemmens
- Department of Head and Skin, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Lesley Verhofstadt
- Department of Experimental Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
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Mohammed S, Yakubu I, Fuseini AG, Abdulai AM, Yakubu YH. Systematic review and meta-analysis of the prevalence and determinants of exclusive breastfeeding in the first six months of life in Ghana. BMC Public Health 2023; 23:920. [PMID: 37208682 PMCID: PMC10199593 DOI: 10.1186/s12889-023-15758-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 04/26/2023] [Indexed: 05/21/2023] Open
Abstract
BACKGROUND Exclusive breastfeeding is a public health priority in sub-Saharan Africa. However, systematic reviews on its determinants in Ghana remain scarce. Therefore, we systematically reviewed the prevalence and determinants of exclusive breastfeeding in children 0-6 months in Ghana. METHODS We conducted systematic searches in Embase, Medline, and Africa-Wide Information from the databases' inception until February 2021 for studies that assessed the prevalence and determinants of exclusive breastfeeding in children 0-6 months in Ghana. Random-effects meta-analysis was used to estimate the pooled prevalence of exclusive breastfeeding and narrative synthesis to summarise the determinants. We calculated the proportion of total variability that was due to between study heterogeneity using I² statistics, and Egger's test assessed publication bias. The review is registered with PROSPERO, CRD42021278019. RESULTS Out of the 258 articles identified, 24 met the inclusion criteria. Most of the included studies were cross-sectional and were published between 2005 and 2021. The pooled prevalence of exclusive breastfeeding (EBF) among children 0-6 months in Ghana was 50% (95%CI 41.0-60.0%). The prevalence was higher in rural areas (54%) than in urban areas (44%). Several factors were identified as facilitators of EBF, including older maternal age, self-employment, unemployment, living in a large house, being a house owner, giving birth in a health facility, non-caesarean delivery, adequate antenatal attendance, counselling services, participation in support groups, adequate knowledge about EBF, positive attitude towards EBF, and higher maternal education among rural dwellers. Additionally, having an average birthweight facilitated EBF. Barriers to EBF were also identified, including higher maternal education among urban dwellers, less than three months of maternity leave, maternal HIV-positive status, the experience of partner violence, lack of access to radio, inadequate breastmilk production, lack of family support, having a partner who wants more children, counselling on complementary feeding, healthcare worker recommendation of complementary feed, single marital status, and infant admission to neonatal intensive care units. CONCLUSION In Ghana, EBF rates are low, with only about half of all children aged 0-6 months breastfed exclusively. A multi-dimensional approach is required to tackle the diverse sociodemographic, obstetric, and infant-related issues that hinder EBF practice in Ghana.
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Affiliation(s)
- Shamsudeen Mohammed
- MedicineDepartment of Non-communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Ibrahim Yakubu
- Department of Paediatrics and Child Health, University of Otago, Wellington, New Zealand.
- Department of Nursing, Nursing and Midwifery Training College, Gushegu, Ghana.
| | | | - Abdul-Malik Abdulai
- Department of Nursing, Nurses' and Midwives' Training College, Tamale, Ghana
| | - Yakubu H Yakubu
- School of Clinical Sciences, Department of Nursing, Auckland University of Technology, Auckland, New Zealand
- Department of Intensive Care Unit, Tamale Teaching Hospital, Tamale, Ghana
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Kanichy (Makah) M, Schmidt L, Anderson R, Njau G, Stiffarm (Aaniiih) A, Schmidt M, Stepanov A, Williams A. Examining the Role of Interpersonal Violence in Racial Disparities in Breastfeeding in North Dakota (ND PRAMS 2017-2019). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085445. [PMID: 37107727 PMCID: PMC10138366 DOI: 10.3390/ijerph20085445] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/01/2023] [Accepted: 04/07/2023] [Indexed: 05/11/2023]
Abstract
BACKGROUND The 2019 overall breastfeeding initiation rate in the US was 84.1%, yet only 76.6% of American Indian (AI) women initiated breastfeeding. In North Dakota (ND), AI women have greater exposure to interpersonal violence than other racial/ethnic groups. Stress associated with interpersonal violence may interfere with processes important to breastfeeding. We explored whether interpersonal violence partially explains racial/ethnic disparities in breastfeeding in ND. METHODS Data for 2161 women were drawn from the 2017-2019 ND Pregnancy Risk Assessment Monitoring System. Breastfeeding questions in PRAMS have been tested among diverse populations. Breastfeeding initiation was self-report to "Did you ever breastfeed or pump breast milk to feed your new baby, even for a short period?" (yes/no). Breastfeeding duration (2 months; 6 months) was self-reported how many weeks or months of breastmilk feeding. Interpersonal violence for both 12 months before and during pregnancy based on self-report (yes/no) of violence from a husband/partner, family member, someone else, or ex-husband/partner. An "Any violence" variable was created if participants reported "yes" to any violence. Logistic regression models estimated crude and adjusted odds ratios (OR) and 95% confidence intervals (95% CI) for breastfeeding outcomes among AI and Other Race women compared to White women. Sequential models were adjusted for interpersonal violence (husband/partner, family member, someone else, ex-husband/partner, or any). RESULTS AI women had 45% reduced odds of initiating breastfeeding (OR: 0.55, 95% CI: 0.36, 0.82) compared to white women. Including interpersonal violence during pregnancy did not change results. Similar patterns were observed for all breastfeeding outcomes and all interpersonal violence exposures. DISCUSSION Interpersonal violence does not explain the disparity in breastfeeding in ND. Considering cultural ties to the tradition of breastfeeding and the role of colonization may provide a better understanding of breastfeeding among AI populations.
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Affiliation(s)
- MichaeLynn Kanichy (Makah)
- Public Health Program, Department of Population Health, School of Medicine & Health Sciences, The University of North Dakota, 1301 North Columbia Road Stop 9037, Grand Forks, ND 58202, USA
| | - Lexie Schmidt
- Public Health Program, Department of Population Health, School of Medicine & Health Sciences, The University of North Dakota, 1301 North Columbia Road Stop 9037, Grand Forks, ND 58202, USA
| | - RaeAnn Anderson
- Department of Psychology, University of North Dakota, 501 North Columbia Road Stop 8380, Grand Forks, ND 58202, USA
| | - Grace Njau
- North Dakota Department of Health & Human Services, 600 East Boulevard Ave, Department 325, Bismarck, ND 58505, USA
| | - Amy Stiffarm (Aaniiih)
- Department of Indigenous Health, School of Medicine & Health Sciences, University of North Dakota, 1301 North Columbia Road Stop 9037, Grand Forks, ND 58202, USA
| | - Matthew Schmidt
- North Dakota Department of Health & Human Services, 600 East Boulevard Ave, Department 325, Bismarck, ND 58505, USA
| | - Anastasia Stepanov
- North Dakota Department of Health & Human Services, 600 East Boulevard Ave, Department 325, Bismarck, ND 58505, USA
| | - Andrew Williams
- Public Health Program, Department of Population Health, School of Medicine & Health Sciences, The University of North Dakota, 1301 North Columbia Road Stop 9037, Grand Forks, ND 58202, USA
- Department of Indigenous Health, School of Medicine & Health Sciences, University of North Dakota, 1301 North Columbia Road Stop 9037, Grand Forks, ND 58202, USA
- Correspondence:
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Andreasen K, Zapata-Calvente AL, Martín-de-Las-Heras S, Bueno-Cavanillas A, Schei B, Dokkedahl S, de León de León S, Fernandez Lopez R, Oviedo-Gutiérrez A, Ankerstjerne LBS, Megías JL, Khan KS, Rasch V, Linde DS. Video Consultations and Safety App Targeting Pregnant Women Exposed to Intimate Partner Violence in Denmark and Spain: Nested Cohort Intervention Study (STOP Study). JMIR Form Res 2023; 7:e38563. [PMID: 36939835 PMCID: PMC10132014 DOI: 10.2196/38563] [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: 04/08/2022] [Revised: 10/19/2022] [Accepted: 01/04/2023] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Intimate partner violence (IPV) during pregnancy is a public health issue with wide-ranging consequences for both the mother and fetus, and interventions are needed. Therefore, the Stop Intimate Partner Violence in Pregnancy (STOP) cohort was established with the overall aim to identify pregnant women exposed to IPV through digital screening and offer women screening positive for IPV a digital supportive intervention. OBJECTIVE The aim of this study was to (1) introduce the design and profile of the STOP cohort study, (2) assess the feasibility of implementing digital IPV screening among pregnant women, and (3) assess the feasibility of implementing a digital supportive intervention targeting pregnant women exposed to IPV. METHODS Pregnant women attending antenatal care in the Region of Southern Denmark and in Andalucía, Spain were offered digital screening for IPV using validated scales (Abuse Assessment Screen and Women Abuse Screening Tool). Women who screened positive were eligible to receive a digital supportive intervention. The intervention consisted of 3-6 video consultations with an IPV counselor and a safety planning app. In Denmark, IPV counselors were antenatal care midwives trained by a psychologist specialized in IPV, whereas in Spain, the counselor was a psychologist. RESULTS Data collection started in February 2021 and was completed in October 2022. Across Denmark and Spain, a total of 19,442 pregnant women were invited for IPV screening and 16,068 women (82.65%) completed the screening. More women in Spain screened positive for exposure to IPV (350/2055, 17.03%) than in Denmark (1195/14,013, 8.53%). Among the women who screened positive, only 31.39% (485/1545) were eligible to receive the intervention with only 104 (21.4%) of these women ultimately receiving it. CONCLUSIONS Digital screening for IPV among pregnant women is feasible in an antenatal care context in Denmark and Spain; however, a digital supportive intervention during pregnancy appears to have limited feasibility as only a minor subgroup of women who screened positive for eligibility received the intervention. More research is needed on how to best support pregnant women exposed to IPV if universal IPV screening is to be implemented in antenatal care.
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Affiliation(s)
- Karen Andreasen
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Gyneacology and Obstetrics, Odense University Hospital, Odense, Denmark
- Open Patient Data Explorative Network, Odense University Hospital, Odense, Denmark
| | | | | | - Aurora Bueno-Cavanillas
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
- Center for Biomedical Research in Epidemiology and Public Health Network-Spain, University of Granada, Granada, Spain
| | - Berit Schei
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Institute of Public Health, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Obstetrics and Gynaecology, Sct. Olavs University Hospital, Trondheim, Norway
| | - Sarah Dokkedahl
- Department of Psychology, University of Southern Denmark, Odense, Denmark
| | | | | | | | - Lea Bo Sønderlund Ankerstjerne
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Gyneacology and Obstetrics, Odense University Hospital, Odense, Denmark
| | - Jesús L Megías
- Brain and Behavior Research Center, University of Granada, Granada, Spain
| | - Khalid Saeed Khan
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
- Center for Biomedical Research in Epidemiology and Public Health Network-Spain, University of Granada, Granada, Spain
| | - Vibeke Rasch
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Gyneacology and Obstetrics, Odense University Hospital, Odense, Denmark
| | - Ditte S Linde
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Gyneacology and Obstetrics, Odense University Hospital, Odense, Denmark
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Leite TH, Marques ES, Mesenburg MA, Freitas da Silveira M, Leal MDC. The effect of obstetric violence during childbirth on breastfeeding: findings from a perinatal cohort "Birth in Brazil". LANCET REGIONAL HEALTH. AMERICAS 2023; 19:100438. [PMID: 36874165 PMCID: PMC9975306 DOI: 10.1016/j.lana.2023.100438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 10/14/2022] [Accepted: 01/13/2023] [Indexed: 02/18/2023]
Abstract
Background Recent literature has shown that many women worldwide are victims of obstetric violence during childbirth. Despite that, few studies are exploring the consequences of such violence on women's and newborn's health. Thus, the present study aimed to investigate the causal association between obstetric violence during childbirth and breastfeeding. Methods We used data from the study "Birth in Brazil", a national hospital-based cohort of puerperal women and their newborns in 2011/2012. The analysis involved 20,527 women. Obstetric violence was a latent variable composed of seven indicators (physical or psychological violence, disrespect, lack of information, privacy and communication with the healthcare team, inability to ask questions, and loss of autonomy). We worked with two outcomes: 1) breastfeeding at the maternity and 2) breastfeeding 43-180 days after birth. We applied multigroup structural equation modelling, based on the type of birth. Findings Obstetric violence during childbirth may decrease the probability for women to leave the maternity ward breastfeeding exclusively, having a stronger effect on women who have vaginal birth. Also, being exposed to obstetric violence during childbirth could indirectly affect those women's ability to breastfeed 43-180 days after birth. Interpretation This research concludes that obstetric violence during childbirth is a risk factor for breastfeeding discontinuation. Such knowledge is relevant so interventions and public policies can be proposed in order to mitigate obstetric violence and provide a better understanding of the context that may lead a woman into discontinuing breastfeeding. Funding This research was funded by CAPES, CNPQ, DeCiT, and INOVA-ENSP.
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Affiliation(s)
- Tatiana Henriques Leite
- Social Medicine Institute, University of the State of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Emanuele Souza Marques
- Social Medicine Institute, University of the State of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | | | | | - Maria do Carmo Leal
- National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
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Atilla R, Yavuz A, Kocaöz S. Exposure of Pregnant Women to Intimate Partner Violence during the Pandemic in Turkey and Influencing Factors. J Community Health Nurs 2023; 40:1-13. [PMID: 36602774 DOI: 10.1080/07370016.2022.2094708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
PURPOSE This research was conducted to determine the exposure of pregnant women to intimate partner violence (IPV) during the Covid-19 pandemic and its influencing factors. DESIGN Cross-sectional study. METHODS This study included 456 pregnant women. The "Pregnant Information Form" and "Intimate Partner Violence During Pregnancy Questionnaire" were used to collect data. FINDINGS Exposure frequency to IPV during the pandemic and curfews were 44.1% and 43.9%, respectively. A significant relationship was found between exposure to IPV and the partner having wage-earning employment, marital relationship during Covid-19, the effect of the pandemic on spousal relationships, and gravida. CONCLUSIONS The prevalence of IPV in pregnant women during and after the pandemic did not change significantly from IPV in pregnant women before the pandemic. CLINICAL EVIDENCE To prevent and reduce partner violence during pregnancy, there is a need to evaluate IPV among women who apply for routine pregnancy examinations.
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Affiliation(s)
- Rabia Atilla
- Zübeyde Hanım Faculty of Health Sciences, Nursing Department, Department of Obstetrics and Gynecology Nursing, Niğde Ömer Halisdemir University, Niğde, Turkey
| | - Adem Yavuz
- Medical Faculty, Surgical Medical Sciences, Department of Obstetrics and Gynecology, Niğde Ömer Halisdemir University, Niğde, Turkey
| | - Semra Kocaöz
- Zübeyde Hanım Faculty of Health Sciences, Nursing Department, Department of Obstetrics and Gynecology Nursing, Niğde Ömer Halisdemir University, Niğde, Turkey
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Do HP, Vo TV, Murray L, Baker PRA, Murray A, Valdebenito S, Eisner M, Tran BX, Luong-Thanh BY, Nguyen LH, Dunne MP. The influence of childhood abuse and prenatal intimate partner violence on childbirth experiences and breastfeeding outcomes. CHILD ABUSE & NEGLECT 2022; 131:105743. [PMID: 35738070 DOI: 10.1016/j.chiabu.2022.105743] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 06/08/2022] [Accepted: 06/12/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Despite the detrimental effects and life-course health consequences of violence exposure, relatively few studies have adequate capacity to investigate the evolution of violence from childhood to motherhood. OBJECTIVE This study aims to examine the cyclical nature of childhood abuse and prenatal inter-partner violent victimization (p-IPV) and its adverse impact on childbirth trauma and exclusive breastfeeding (EBF) practice in Vietnam. METHOD Using a prospective birth cohort, 150 pregnant women were recruited in the third trimester of pregnancy in Hue city in central Vietnam (Wave 1-Baseline) and re-interviewed approximately three months after delivery (Wave 2-Follow-up). The direct and indirect effects of violent victimization on subsequent childbirth experience (measured by Birth Memories and Recall Questionnaire) and EBF practice were estimated by using augmented-inverse-probability-weighted models, sensitivity analysis, and structural equation model. RESULTS Detrimental and prolonged effects of the inter-generational cycle of violence transverse childhood to motherhood. Women who experienced either childhood abuse or p-IPV violence were more likely to experience negative emotional childbirth memories [ARR 1.21, 95 % CI (1.04, 1.39)]. Evidence also suggested that not continuing to exclusively breastfeed at 3 months post-partum was strongly associated with prenatal depression, young age, and perceived low social status during pregnancy. Perceived strong connectedness among extended family members and social networks (i.e. nexus among family, friends, and neighborhood) provided a buffering effect by preventing EBF termination. CONCLUSION This research provides insights into the protective role of social connectedness in improving breastfeeding practice. It is vital to establish wholistic antenatal care and social service system to offer specialized support and response for victims of violence and mitigate the long-term sequelae of traumatic events.
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Affiliation(s)
- Huyen Phuc Do
- Queensland University of Technology (QUT), Faculty of Health, School of Public Health and Social Work, Brisbane, Australia; Institute of Health Economics and Technology, Hanoi, Viet Nam.
| | - Thang Van Vo
- Institute for Community Health Research, University of Medicine and Pharmacy, Hue University, Hue City, Viet Nam; Faculty of Public Health, University of Medicine and Pharmacy, Hue University, Hue city, Viet Nam.
| | - Linda Murray
- College of Health Sciences, Massey University, New Zealand.
| | - Philip R A Baker
- Queensland University of Technology (QUT), Faculty of Health, School of Public Health and Social Work, Brisbane, Australia.
| | - Aja Murray
- Department of Psychology, University of Edinburgh, United Kingdom.
| | - Sara Valdebenito
- Institute of Criminology, University of Cambridge, United Kingdom.
| | - Manuel Eisner
- Institute of Criminology, University of Cambridge, United Kingdom.
| | - Bach Xuan Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Viet Nam; Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Bao-Yen Luong-Thanh
- Institute for Community Health Research, University of Medicine and Pharmacy, Hue University, Hue City, Viet Nam; Faculty of Public Health, University of Medicine and Pharmacy, Hue University, Hue city, Viet Nam.
| | - Lan Hoang Nguyen
- Institute for Community Health Research, University of Medicine and Pharmacy, Hue University, Hue City, Viet Nam; Faculty of Public Health, University of Medicine and Pharmacy, Hue University, Hue city, Viet Nam.
| | - Michael P Dunne
- Institute for Community Health Research, University of Medicine and Pharmacy, Hue University, Hue City, Viet Nam; Australian Centre for Health Law Research, Faculty of Business and Law, Queensland University of Technology (QUT), Australia.
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Aristizábal LYG, Theme Filha MM. Physical violence against women by their intimate partner during pregnancy and its relationship with breastfeeding. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2022. [DOI: 10.1590/1806-9304202200020004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Abstract Objectives: to estimate the association between physical violence against women by their intimate partner during pregnancy and breastfeeding. Methods: the data source is the 2010 National Demographic and Health Survey (DHS) conducted in Colombia, and 11,416 mother-child dyads were analysed. The relationship between physical violence against women by their partner during pregnancy and breastfeeding indicators was carried out using the weighted propensity score from the Inverse Probability of Treatment Weighting (IPTW). Variables for adjustment were selected through the Directed Acyclic Diagram (DAG) and performed a sensitivity analysis to identify the strength of hidden bias. Results: according to the data, 6.4% (730) of the women suffered physical violence by their partner during their pregnancy. The median time of exclusive breastfeeding was 1.0 month. No statistically significant relationship was observed with any of the breastfeeding indicators analysed: exclusive breastfeeding (OR=1.17; CI95%=0.82-1.67); breastfeeding at any time (OR=1.61; CI95%=0.58-2.60); and initiation of breastfeeding (OR=1.07; CI95%=0.74-1.2) Conclusion: although the association between violence against women committed during pregnancy and breastfeeding indicators was not found, the suboptimal breastfeeding practices and high prevalence of violence against women by the partner are two major public health issues in Colombia. Prenatal care professionals can change this scenario by identifying women exposed to intimate partner violence and offering tailored support for breastfeeding practices.
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Dirirsa DE, Desta AA, Geleta TA, Gemmechu MM, Melese GT, Abebe ST. Intimate partner violence in the postpartum period and its associated factors among women attending a postnatal clinic in Central Ethiopia. SAGE Open Med 2022; 10:20503121221100136. [PMID: 35646358 PMCID: PMC9130815 DOI: 10.1177/20503121221100136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 04/25/2022] [Indexed: 12/02/2022] Open
Abstract
Objective: Intimate partner violence may affect women at any stage of their lives,
including during pregnancy and after childbirth, and can have major health
consequences for both the mother and the child. Therefore, the study was
aimed to assess Intimate partner violence against postpartum women and its
associated factors among women attending the postpartum clinic in Central
Ethiopia, 2021. Methods: The hospital based cross-sectional study design was implemented among
postpartum women attending Sendafa Beke Hospital from September to October
2021. Systematic random sampling procedure was used to select 414 eligible
postpartum women. Data were collected using a structured interviewer
administered questionnaire. The data were entered into Epi Info and exported
to SPSS version 24 for analysis. All variables with p-value < 0.05 under
adjusted odds ratio were taken as statistical significant associated factors
with postpartum intimate partner violence. Results: A total of 414 postpartum women participated in the study with a 97% of
response rate. The prevalence of postpartum intimate partner violence was
31.4%. The study identified that monthly income 1000–5000 birr (adjusted
odds ratio = 3.4; 95% confidence interval = 1.08, 10.5), partners’ alcohol
consumption (adjusted odds ratio = 0.17, 95% confidence interval = 0.06,
0.45), decision-maker of household affairs (adjusted odds ratio = 4.8; 95%
confidence interval = 1.5, 15.1), and infant’s sex (adjusted odds
ratio = 0.03; 95% confidence interval = 0.02, 0.063) were significantly
associated with postpartum intimate partner violence. Conclusion: According to the findings of this study, nearly one-third of postpartum women
were violated by their intimate partner after childbirth. Postpartum
intimate partner violence was found to be associated with monthly income,
partners’ alcohol intake, decision-maker of household affairs, and infant’s
sex. To reduce the magnitude of the problem, different efforts should
require from health professional, community, and government. The policy
makers, planners and other concerned bodies establish appropriate strategy
to prevent and control violence against women.
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Affiliation(s)
- Dejene Edosa Dirirsa
- Department of Midwifery, College of Health and Medical Sciences, Salale University, Fiche, Ethiopia
| | - Adugna Alemu Desta
- Department of Midwifery, College of Health and Medical Sciences, Salale University, Fiche, Ethiopia
| | - Tinsae Abeya Geleta
- Department of Public Health, College of Health and Medical Sciences, Salale University, Fiche, Ethiopia
| | | | - Girma Tufa Melese
- Department of Midwifery, College of Health and Medical Sciences, Bule Hora University, Bule Hora, Ethiopia
| | - Shimellis Tadese Abebe
- Department of Midwifery, College of Health and Medical Sciences, Mettu University, Metu, Ethiopia
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14
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Martínez-Vázquez S, Hernández-Martínez A, Rodríguez-Almagro J, Peinado-Molina RA, Martínez-Galiano JM. Determinants and Factors Associated with the Maintenance of Exclusive Breastfeeding after Hospital Discharge after Birth. Healthcare (Basel) 2022; 10:healthcare10040733. [PMID: 35455909 PMCID: PMC9028310 DOI: 10.3390/healthcare10040733] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 03/30/2022] [Accepted: 04/12/2022] [Indexed: 11/26/2022] Open
Abstract
The benefits of exclusive breastfeeding are well known for both mother and baby. Despite this, rates of exclusive breastfeeding remain low. The present study aimed to determine the factors associated with the maintenance of this type of feeding after being discharged from the hospital after childbirth. A cross-sectional study was carried out with 1200 postpartum women in Spain. Sociodemographic, obstetric, and neonatal data were collected. Odds ratios (OR) and adjusted odds ratios (aOR) with 95% confidence intervals were calculated. Early breastfeeding initiation was identified as a factor that favors breastfeeding after hospital discharge (aOR: 2.47; 95%CI: 1.77, 3.45). Other factors that favor breastfeeding after discharge included the woman feeling very supported by her partner during pregnancy, childbirth, and the puerperium (aOR: 2.54; 95%CI:1.30, 5.00) and having previously breastfed other children (aOR: 1.97; 95%CI: 1.40, 2.76). Among the factors that hindered exclusive breastfeeding after discharge were multiple or twin pregnancies (aOR: 0.31; 95%CI 0.12, 0.83), induction of labor (aOR: 0.73; 95%CI: 0.53, 0.99), admission of the newborn to the neonatal intensive care unit (NICU) (aOR: 0.31; 95%CI 0.19, 0.52), using epidural pain relief during labor (aOR: 0.41; 95%CI: 0.27, 0.64), or a preterm newborn (aOR: 0.38; 95%CI: 0.21, 0.69). For all these reasons, it is essential to promote certain practices such as the early start of breastfeeding or the induced onset of labor, among others, in order to promote the maintenance of exclusive breastfeeding beyond hospital discharge after childbirth.
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Affiliation(s)
| | - Antonio Hernández-Martínez
- Department of Nursing, Faculty of Nursing of Ciudad Real, University of Castilla-La Mancha, 13071 Ciudad Real, Spain; (A.H.-M.); (J.R.-A.)
| | - Julián Rodríguez-Almagro
- Department of Nursing, Faculty of Nursing of Ciudad Real, University of Castilla-La Mancha, 13071 Ciudad Real, Spain; (A.H.-M.); (J.R.-A.)
| | | | - Juan Miguel Martínez-Galiano
- Department of Nursing, University of Jaen, 23071 Jaen, Spain;
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-953-211-740
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15
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D’Angelo DV, Bombard JM, Lee RD, Kortsmit K, Kapaya M, Fasula A. Prevalence of Experiencing Physical, Emotional, and Sexual Violence by a Current Intimate Partner during Pregnancy: Population-based Estimates from the Pregnancy Risk Assessment Monitoring System. JOURNAL OF FAMILY VIOLENCE 2022; 38:117-126. [PMID: 37205924 PMCID: PMC10193455 DOI: 10.1007/s10896-022-00356-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/09/2022] [Indexed: 05/21/2023]
Abstract
Intimate partner violence (IPV) during pregnancy presents a risk for maternal mental health problems, preterm birth, and having a low birthweight infant. We assessed the prevalence of self-reported physical, emotional, and sexual violence during pregnancy by a current partner among women with a recent live birth. We analyzed data from the 2016-2018 Pregnancy Risk Assessment Monitoring System in six states to calculate weighted prevalence estimates and 95% confidence intervals for experiences of violence by demographic characteristics, health care utilization, and selected risk factors. Overall, 5.7% of women reported any type of violence during pregnancy. Emotional violence was most prevalent (5.4%), followed by physical violence (1.5%), and sexual violence (0.9%). Among women who reported any violence, 67.6% reported one type of violence, 26.5% reported two types, and 6.0% reported three types. Reporting any violence was highest among women using marijuana or illicit substances, experiencing pre-pregnancy physical violence, reporting depression, reporting an unwanted pregnancy, and experiencing relationship problems such as getting divorced, separated, or arguing frequently with their partner. There was no difference in report of discussions with prenatal care providers by experience of violence. The majority of women did not report experiencing violence, however among those who did emotional violence was most frequently reported. Assessment for IPV is important, and health care providers can play an important role in screening. Coordinated prevention efforts to reduce the occurrence of IPV and community-wide resources are needed to ensure that pregnant women receive needed services and protection.
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Affiliation(s)
- Denise V. D’Angelo
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Hwy. NE, Mail stop S106-10, GA 30341 Atlanta, USA
| | - Jennifer M. Bombard
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Rosalyn D. Lee
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Hwy. NE, Mail stop S106-10, GA 30341 Atlanta, USA
| | - Katherine Kortsmit
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Martha Kapaya
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Amy Fasula
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
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16
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Mazza M, Caroppo E, Marano G, Chieffo D, Moccia L, Janiri D, Rinaldi L, Janiri L, Sani G. Caring for Mothers: A Narrative Review on Interpersonal Violence and Peripartum Mental Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5281. [PMID: 34065628 PMCID: PMC8156346 DOI: 10.3390/ijerph18105281] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 05/13/2021] [Accepted: 05/14/2021] [Indexed: 01/07/2023]
Abstract
Interpersonal violence in the perinatal period is frequent and should be considered a prominent health issue due to the risk of escalation of violence and the significant impact on mothers' parenting after childbirth. Domestic violence during pregnancy can be associated with fatal and non-fatal adverse health outcomes due to the direct trauma to a pregnant woman's body and to the effect of stress on fetal growth and development. Emotional violence is a risk factor for prenatal and/or postpartum depression. Recent studies focusing on abusive situations during peripartum and possible preventive strategies were identified in PubMed/Medline, Scopus, Embase, and ScienceDirect. All of the available literature was retrospectively reviewed with a special attention to peer-reviewed publications from the last ten years. Results of the present narrative review suggest that perinatal health care professionals (general practitioners, gynecologists, obstetricians, psychologists, psychiatrists) should promptly detect interpersonal violence during and after pregnancy and provide health care for pregnant women. It seems pivotal to guarantee psychological care for abused women before, during, and after pregnancy in order to prevent the risk of depressive symptoms, other mental or physical sequelae, and mother-to-infant bonding failure. There is an urgent need for multifaceted interventions: programs should focus on several risk factors and should design tailored care pathways fitted to the specific needs of women and finalized to support them across the lifespan.
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Affiliation(s)
- Marianna Mazza
- Department of Psychiatry, Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy; (G.M.); (L.M.); (D.J.); (L.R.); (L.J.); (G.S.)
- Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
| | - Emanuele Caroppo
- Department of Mental Health, Health Local Unit ASL ROMA 2, 00159 Rome, Italy;
| | - Giuseppe Marano
- Department of Psychiatry, Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy; (G.M.); (L.M.); (D.J.); (L.R.); (L.J.); (G.S.)
- Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
| | - Daniela Chieffo
- Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
- Service of Clinical Psychology, Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy
| | - Lorenzo Moccia
- Department of Psychiatry, Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy; (G.M.); (L.M.); (D.J.); (L.R.); (L.J.); (G.S.)
- Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
| | - Delfina Janiri
- Department of Psychiatry, Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy; (G.M.); (L.M.); (D.J.); (L.R.); (L.J.); (G.S.)
- Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
| | - Lucio Rinaldi
- Department of Psychiatry, Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy; (G.M.); (L.M.); (D.J.); (L.R.); (L.J.); (G.S.)
- Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
| | - Luigi Janiri
- Department of Psychiatry, Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy; (G.M.); (L.M.); (D.J.); (L.R.); (L.J.); (G.S.)
- Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
| | - Gabriele Sani
- Department of Psychiatry, Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy; (G.M.); (L.M.); (D.J.); (L.R.); (L.J.); (G.S.)
- Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
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