Association between Intimate Partner Violence during Pregnancy and Adverse Pregnancy Outcomes in Vietnam: A Prospective Cohort Study

Understanding the barriers to integrating maternal and mental health at primary health care in Vietnam

The prevalence of common perinatal mental disorders in Vietnam ranges from 16.9% to 39.9%, and substantial treatment gaps have been identified at all levels. This paper explores constraints to the integration of maternal and mental health services at the primary healthcare level and the implications for the health system's responsiveness to the needs and expectations of pregnant women with mental health conditions in Vietnam. As part of the RESPONSE project, a three-phase realist evaluation study, we present Phase 1 findings, which employed systematic and scoping literature reviews and qualitative data collection (focus groups and interviews) with key health system actors in Bac Giang province, Vietnam, to understand the barriers to maternal mental healthcare provision, utilization and integration strategies. A four-level framing of the barriers to integrating perinatal mental health services in Vietnam was used in reporting findings, which comprised individual, sociocultural, organizational and structural levels. At the sociocultural and structural levels, these barriers included cultural beliefs about the holistic notion of physical and mental health, stigma towards mental health, biomedical approach to healthcare services, absence of comprehensive mental health policy and a lack of mental health workforce. At the organizational level, there was an absence of clinical guidelines on the integration of mental health in routine antenatal visits, a shortage of staff and poor health facilities. Finally, at the provider level, a lack of knowledge and training on mental health was identified. The integration of mental health into routine antenatal visits at the primary care level has the potential help to reduce stigma towards mental health and improve health system responsiveness by providing services closer to the local level, offering prompt attention, better choice of services and better communication while ensuring privacy and confidentiality of services. This can improve the demand for mental health services and help reduce the delay of care-seeking.

Violence Against Women as a Global Public Health Issue

Violence against women, especially intimate partner violence, is recognized as a global public health issue due to its prevalence and global reach. This article outlines the scope of the issue, with respect to its prevalence, health outcomes, and risk factors, and identifies key milestones that led to its global recognition: methodological and data advances, acknowledgment as a criminal justice and health issue, support by the global women's movement, and the robust evidence demonstrating that intimate partner violence is preventable. Key issues for the future include recognition and consideration of intersectionality in research, improvements in the measurement of other forms of violence against women, and the need to scale up prevention efforts that have documented success. Violence against women is an urgent priority as it affects individuals, their families and surroundings, and the entire global health community.

Linkages between maternal experience of intimate partner violence and child nutrition outcomes: A rapid evidence assessment

BACKGROUND

A strong evidence base indicates that maternal caregivers' experience of intimate partner violence [IPV] impacts children's health, cognitive development, and risk-taking behaviors. Our objective was to review peer-reviewed literature describing the associations between a child's indirect exposure to IPV and corresponding nutrition outcomes, with a particular focus on fragile settings in low and middle-income countries [LMICs].

METHODS

We conducted a rapid evidence assessment to synthesize quantitative associations between maternal caregivers' IPV experience and children's nutrition/growth outcomes (birthweight, feeding, and growth indicators). We included peer-reviewed research, published in English or Spanish after the year 2000, conducted in fragile settings in LMICs.

RESULTS

We identified 86 publications that fit inclusion criteria. Amongst all associations assessed, a maternal caregiver's experience of combined forms of IPV (physical, sexual and emotional) or physical IPV only, were most consistently associated with lower birthweight, especially during pregnancy. Women of child-bearing age, including adolescents, exposed to at least one type of IPV showed a decreased likelihood of following recommended breastfeeding practices. Lifetime maternal experience of combined IPV was significantly associated with stunting among children under 5 years of age in the largest study included, though findings in smaller studies were inconsistent. Maternal experience of physical or combined IPV were inconsistently associated with underweight or wasting in the first five years. Maternal experience of sexual IPV during pregnancy appeared to predict worsened lipid profiles among children.

CONCLUSION

Maternal caregivers' experience of IPV is significantly associated with low birthweight and suboptimal breastfeeding practices, whereas studies showed inconsistent associations with child growth indicators or blood nutrient levels. Future research should focus on outcomes in children aged 2 years and older, investigation of feeding practices beyond breastfeeding, and examination of risk during time periods physiologically relevant to the outcomes. Programmatic implications include incorporation of GBV considerations into nutrition policies and programming and integrating GBV prevention and response into mother and child health and nutrition interventions in LMIC contexts.

Intimate partner violence during pregnancy and its association with birth asphyxia in hospitals of Tigray region, Ethiopia

BACKGROUND

Birth asphyxia is the main cause of neonatal mortality and morbidity worldwide. Some studies indicate intimate partner violence during pregnancy is a risk factor for birth asphyxia. In Ethiopia, intimate partner violence during pregnancy is reported to be high. Despite this high prevalence, there is a lack of data about the association of birth asphyxia and intimate partner violence. The aim of this study was to assess the prevalence of intimate partner violence during pregnancy and its associated factors with birth asphyxia in health facilities in the Tigray region of northern Ethiopia.

METHODS

This was an institutional-based cross-sectional study conducted at select health facilities in the Tigray region of Ethiopia. Random sampling technique was employed to select health facilities and systematic sampling was used to select 648 study participants. Data was entered by using Epi info version 3.5.1 and was analyzed using SPSS version 20. Bivariate and multivariate analysis was done to assess the association between exposure to intimate partner violence during pregnancy and birth asphyxia after adjusting for possible confounders.

RESULTS

The prevalence of intimate partner violence during pregnancy was 47(7.3%). Eighty two (12.7%) babies were delivered with birth asphyxia. Intimate partner violence during pregnancy had a significant association with birth asphyxia, AOR (95% CI) = 4.4(2-9.8). In addition to this, other factors that were associated with birth asphyxia include place of residence [ AOR (95% CI) = 2.7(1.55-4.8)], age > 19 [AOR (95% CI) = 2.9(1.29-6.5)], age 20-35 [AOR (95% CI) = 3.1(1.06-9.3)], gestational age < 37 weeks [AOR(95% CI) = 7.2(3.5-14.8)] and low birth weight [AOR(95% CI) = 3.9(2.1-7.3)].

CONCLUSIONS

The prevalence of birth asphyxia in this study is high and is further increased by intimate partner violence during pregnancy. Health care providers and policy makers should take measures aimed at preventing intimate partner violence during pregnancy to reduce harm to the mother and adverse birth outcomes.

Intimate partner violence during pregnancy and risks of low birth weight and preterm birth in hospitals of Tigray, Northern Ethiopia

Intimate partner Violence (IPV) can affect any woman, irrespective of their economic status, religion, or culture. This is a human-rights issue and due to its prevalence and adverse effects on pregnancy and birth, it must be given greater attention. Further, there is a lack of data in the Tigray region about adverse birth outcomes due to intimate partner violence during pregnancy. The aim of this study was to assess intimate partner violence during pregnancy and its association with low birth weight and preterm birth in Tigray region. Across-sectional study design was used. 647 women were involved in the study. Simple random sampling techniques were employed to select health facilities and systematic sampling was used to select study participants. Data were entered using Epi info version 3.5.1 and was analyzed using SPSSversion 20. Logistic regression analysis was conducted to assess the association between exposure to intimate partner violence during pregnancy and preterm birth and low birth weight while adjusting for possible confounders. The prevalence of intimate partner violence during pregnancy was 7.3% and the prevalence of low birth weight and preterm birth were 18.5% and 10.8% respectively. There was a statistically significant association between exposure to intimate partner violence during pregnancy and low birth weight. After adjustment for socioeconomic status, women's habits and obstetric factors, the pregnant women who were exposed to intimate partner violence during pregnancy were two times more likely to have a child with a low birth weight (2.39 (95% CI: 1.26-4.55)). The prevalence of intimate partner violence during pregnancy, low birth weight, and preterm birth in this study was high. Women who experienced intimate partner violence during pregnancy had an increased risk of low birth weight. These findings justify a call to the federal minster of health to take measures aimed at avoiding intimate partner violence during pregnancy to reduce adverse birth outcomes.

Frequency of domestic violence in pregnancy and its adverse maternal outcomes among Pakistani women

Objective

To determine the frequency of domestic violence in pregnancy and its adverse maternal outcomes among Pakistani women.

Material and methods

This was a prospective descriptive longitudinal study conducted at the Department of Obstetrics & Gynecology of Jinnah Postgraduate Medical Center, Karachi from October 2021 to March 2022. The questionnaire was filled during an interview. First part included demographic profile, second part comprised of 5 items with 'yes' or 'no' options. Any positive answer meant woman was subjected to abuse. Adverse maternal outcome was also assessed.

Results

Out of a total of 105 pregnant women, 43(41%) women suffered domestic violence. Verbal or emotional violence (39%) was the most common type of violence. In our study, anemia (71.4%) was the most common complication. Preterm labor (63.8%) was the second on the list. was significantly associated with domestic violence (P-value<0.05). Educational status, employment status, substance abuse, and household monthly income of spouse had a significant association (P-value<0.05) with domestic violence.

Conclusion

Our study shows that high frequency of violence at the time of pregnancy is related to negative maternal outcomes. Women should be screened for violence and support services for such women should be provided in the country.

The impact of intimate partner violence on adverse birth outcomes in public health facilities. A prospective cohort study

BACKGROUND

During pregnancy, intimate partner violence (IPV) is a health problem associated with severe adverse birth outcomes. The Ethiopian Demographic Health Survey showed that more than one-third of married women faced IPV. Therefore, this study aimed to investigate the effects of IPV during pregnancy on adverse birth outcomes.

METHODS

A prospective cohort study was conducted from September 1st, 2021 to April 30th, 2022. Using a systematic random sampling technique, participants were enrolled from 20 to 24 weeks of gestation at antenatal visits at the selected public health institutions. The validated and modified standards of the World Health Organization Domestic Violence Questionnaire were used to screen for IPV. Bivariate and multivariate logistic regression models were used in this study. The relative risk was also calculated to predict the occurrence of adverse birth outcomes.

RESULTS

Overall, 701 pregnant women were followed from 20 to 24 weeks of gestation until delivery in a 1:2 ratio (244 exposed to 457 non-exposed). Preterm birth increased by 1.02 times (RR=1.02, 95 CI; 0.979-1.047), low birth weight with RR= 2.023, 95% CI; 1.201-3.407 and stillbirth (RR= 1.124, 95%CI; 0.43-3.055). Among the exposed groups, 167(23.8%), 83 (11.8%), and 51 (7.3%) had emotional, physical, and sexual violence, respectively. The odds of developing adverse birth outcomes from IPV exposure were [AOR=1.63,95% CI: [1.23, 3.75], emotional violence [AOR= 1.70:95% CI: [1.24, 4.24], and physical violence [AOR= 3.99:95% CI: [1.51, 10.52] times higher than those of their counterparts. No significant association was observed between sexual violence and adverse birth outcomes. Being unsupported by the husband and having previous adverse birth outcomes increased IPV by nearly four-fold [AOR=3.80:95% CI; 1.19, 12.09] and [AOR= 3.70:95% CI:1.49, 9.17], respectively. The odds of mothers with a 2nd visit MUAC measurement of < 23 cm were [AOR=2.81:95% CI; 1.20, 6.61].

CONCLUSION

The incidence of adverse birth outcomes was significantly higher in the physically IPV-exposed group than in the non-exposed group. Therefore, pregnant women should be screened for IPV during their antenatal period. Thus, IPV-exposed pregnant women should be counseled and closely followed up.

Maternal and Fetal Outcomes Among Pregnant Women Exposed to Violence

Introduction Domestic violence against women is now widely recognized as a public health issue and a major human rights violation on a global scale. It is a significant risk factor for women's health problems. Pregnancy places a woman under significant physical and psychological pressure, even without additional stressors like abuse. This pressure can have a negative impact on both the mother's and the child's health. This study aims to assess the prevalence of violence among pregnant women and to determine the maternal and fetal outcomes among pregnant women exposed to violence. Materials and methods This cross-sectional study was conducted among 347 postpartum women to assess maternal and fetal outcomes among those who were exposed to violence during their pregnancy. A face-to-face interview was done using one tool with three parts to collect the necessary data. Part one included socio-demographic characteristics and reproductive history for participants, part two included safe and validated dates-physical violence victimization scale, and part three included maternal and fetal outcomes. Result The findings of this study showed that the prevalence of victimization occurred one to three times (28.8%), while 11.5% of victimization occurred four to nine times, and 2.6% of victimization occurred 10 times or more. Many factors play a role in violence, including family income, husband's jobs, husband smoking, being forced into marriage, a higher number of children, and parity. Additionally, it was discovered that adverse pregnancy and fetal outcomes include preterm birth (PTB), early onset of labor, low birth weight (LBW), and neonatal admission to the intensive care unit. Conclusion The result indicates that violence against pregnant women is at a significant rate. Their findings show that there are several factors that may have caused this percentage. Among the factors that contributed to violence in this study were family income, smoking, husbands' work, forced marriage, the number of pregnancies, and the number of children. To reduce violence during pregnancy, it is crucial to empower women, especially those without a source of income of their own. It is also critical to educate partners and foster healthy relationships between partners.

Intimate partner violence during pregnancy among married women in Putalibajar municipality, Nepal

Introduction

Intimate partner violence during pregnancy (IPVDP) is increasingly being recognized as a significant problem in the developing world due to its adverse health consequences on both pregnant women and children. The objective of the study is to measure the magnitude of intimate partner violence during pregnancy and the factors associated with IPVDP.

Methods

A community-based cross-sectional study was conducted among 263 married women in their extended postpartum period between October 2019 and March 2020 in Putalibajar municipality, Nepal. A face-to-face interview was conducted and data were collected using an interview schedule. A Chi-square test and logistic regression analysis were performed to examine the association between IPVDP and the independent variables.

Results

Among the 263 women interviewed, 30% experienced IPV during pregnancy, the most common type of violence was controlling behavior (20.2%) followed by emotional (18.6%), sexual (10.6%), economic (6.1%), and physical violence (5.3%). It was observed that IPV was more likely to occur among women whose husbands consumed alcohol (AOR = 3.171; CI 95%: 1.588-9.167), women whose husbands consumed tobacco (AOR =3.815; CI 95%: 2.157-7.265), women who sometimes received family support during pregnancy (AOR =2.948; CI 95%: 1.115-7.793) and women who did not decide on marriage timing (AOR =2.777; CI 95%: 1.331-5.792).

Conclusion

Three out of ten pregnant women experienced IPVDP. To prevent violence, and ensure women's empowerment, formulating strict laws and discouraging the element of a violent milieu is important.

Associations between intimate partner violence and adverse birth outcomes during pregnancy: a systematic review and meta-analysis

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/.

Using the WHO Self-Reporting Questionnaire-20 (SRQ-20) to Detect Symptoms of Common Mental Disorders among Pregnant Women in Vietnam: a Validation Study

Purpose

Detection of antenatal common mental disorders in low-resource settings like Vietnam is important and requires a reliable, valid and practical screening tool. Currently, there is no such tool validated for use among pregnant women in Vietnam. This study aims to assess the validity of the Vietnamese version of the 20-item Self Reporting Questionnaire (SRQ-20) by evaluating its reliability, factorial structure, and performance in detecting common mental disorder (CMD) symptoms, thereby identifying the optimum cut-off score for CMD screening among pregnant women in Vietnam.

Participants and Methods

A total of 210 pregnant women from four rural communes participated in a face-to-face interview using the Vietnamese version of the SRQ-20, followed by a clinical diagnostic interview based on ICD-10 diagnostic criteria of CMDs. The reliability of the SRQ-20 was assessed by calculating the scale's Cronbach's alpha to measure internal consistency. Factor analyses were undertaken to examine the factor structure of the instrument. The Receiver Operating Characteristic (ROC) curve analysis was performed to assess the performance of the SRQ-20 against the clinical diagnosis and to identify the optimum cut-off score.

Results

Internal consistency was good, with a Cronbach's alpha of 0.87. Factor analyses resulted in a 4-factor solution. The area under the ROC curve (AUC) for detection of CMDs was 0.90. The optimum cut-off score of the SRQ-20 for detection of CMD symptoms among Vietnamese pregnant women was 5/6.

Conclusion

The Vietnamese version of the SRQ-20 has the capacity to detect CMDs among pregnant women effectively and is recommended for use as a screening tool for CMDs in antenatal care settings in Vietnam.

Video Consultations and Safety App Targeting Pregnant Women Exposed to Intimate Partner Violence in Denmark and Spain: Nested Cohort Intervention Study (STOP Study)

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.

The bayesian approach of factors associated with preterm birth among mothers delivered at public hospitals in Southeast Ethiopia

Background

Preterm birth remains the commonest cause of neonatal mortality, and morbidity represents one of the principal targets of neonatal healthcare. Ethiopia is one of the countries which accounts for the highest burden of preterm birth. Therefore, this study aimed to assess factors associated with preterm birth at public hospitals in Sidama regional state.

Methods

A facility-based cross-sectional study was conducted at public hospitals in Southeast Ethiopia from 1 June to 1 September 2020. To recruit the study participants, systematic random sampling techniques were used. Data were collected using pretested structured interviewer-administered questionnaire and a checklist via chart review. Data were entered using EpiData version 3.1 and exported to R software version 4.0 for analysis. Then, factors associated with preterm birth among mothers were assessed based on the Bayesian statistical approach.

Results

The study showed that the prevalence of preterm birth was 20.6%. Being a rural resident (AOR = 2; 95% CrI: 1.2-3.5), having no antenatal care service utilization (AOR = 2.3; 95% CrI: 1.1-4.8), hypertensive disorder of pregnancy (AOR = 3.5; 95% CrI: 1.8-6.9), birth space less than 2 years (AOR = 3.4; 95% CrI: 1.5-7.9), having premature rupture of membrane (AOR = 2.4; 95% CrI: 1.3-5.4), and physical intimate violence (AOR = 2.876; 95%CI: 1.534, 5.393) were risk factors of preterm birth. Whereas, women who had primary, secondary, and higher education levels (AOR = 0.2; 95% CrI: 0.1-0.4, AOR = 0.1; 95% CrI: 0.06-0.3, and AOR = 0.2; 95% CrI: 0.1-0.4), respectively, were preventive factors.

Conclusion

Most of the risk factors of preterm birth were found to be modifiable. Community mobilization on physical violence during pregnancy and antenatal care follow-up are the ground for the prevention of preterm birth because attentive and critical antenatal care screening practices could early identify risk factors. In addition, information communication education about preterm birth prevention was recommended.

Intimate partner violence during pregnancy and adverse birth outcomes in Ethiopia: A systematic review and meta-analysis

BACKGROUND

Intimate partner violence is a significant public health issue that affects maternal and neonatal health worldwide. Several studies have been conducted to investigate the prevalence of intimate partner violence during pregnancy as well as the factors that contribute to it. As a result, the purpose of this study was to determine the impact of intimate partner violence on birth outcomes.

METHODS

International databases including Scopus, PubMed, Google Scholar, Embase, and CINAHL were used to search primary studies. The quality and strength of the included studies were evaluated using the Newcastle-Ottawa Scale quality assessment tool. The studies heterogeneity and publication biases were assessed using I2 statistics and Egger's regression test. The Meta-analysis was carried out using STATA version 16 software.

RESULTS

A total of nine hundred and fifty-eight articles were retrieved from various databases, and seventeen articles were included in the review. The pooled prevalence of intimate violence during pregnancy in Ethiopia was 32.23% (95% CI 28.02% -36.45%). During pregnancy, intimate partner violence was a significant predictor of low birth weight (AOR: 3.69, 95%CI 1.61-8.50) and preterm birth (AOR: 2.23, 95%CI 1.64-3.04).

CONCLUSION

One in every three pregnant women experiences intimate partner violence. Women who experienced intimate partner violence during their pregnancy are more likely to experience adverse outcomes such as premature delivery and low birth weight infants.

Birth weight was associated with maternal exposure to intimate partner violence during pregnancy in southern Ethiopia: A prospective cohort study

Introduction

Birth weight is defined as the first weight of the newborn, ideally measured soon after birth. A recent Ethiopian survey estimated that 48% of births took place in health facilities. Data for women exposed to intimate partner violence (IPV) may be lacking in official statistics because these women may prefer to deliver at home, where data from non-institutional births, including reporting of birth weights, are not routinely recorded.

Objective

The aim of this study was to investigate the association between maternal exposure to IPV during pregnancy and birth weight in a community in the Wondo Genet district of southern Ethiopia.

Methods

We carried out a community-based prospective cohort study from February to December 2017. We followed up with 505 pregnant women and their newborns until after delivery. An interview about partner violence was done during pregnancy at home when enrolled. Field assistants who visited the homes measured the birth weight of each baby in grams. Twins and late birth weight measurements were excluded. Factors associated with birth weight were assessed by multiple linear regression.

Results

Birth weight was assessed within 48 h for 477 (94.5%) newborns and between 48 and 72 h for an additional 28 (5.5%). There were 365 (72.3%) institutional deliveries. In an adjusted regression analysis (IPV adjusted for socio-economic status), birth weight was 203 g lower (B -203 95% CI -320 to -87) among newborns of women exposed to IPV than among the unexposed. Birth weight was also lower in girls than in boys, in newborns delivered at home rather than in a health facility, and in babies with a younger gestational age.

Conclusion

Maternal exposure to IPV during pregnancy was associated with lower baby birth weights. Antenatal clinics should consider routinely identifying IPV-exposed women, and identifying babies with lower birth weights at home is an important indicator.

The relationship between domestic violence against women, adaptation to pregnancy and maternal-fetal antenatal attachment

PURPOSE

This study aimed to determine the relationship between domestic violence against women, adaptation to pregnancy, and maternal-fetal antenatal attachment.

DESIGN AND METHODS

The study consisted of 385 pregnant women who were referred to the antenatal clinics of a public hospital in eastern Turkey. The data were collected using the Domestic Violence against Women Scale (DVAWS), the Maternal-Fetal Antenatal Attachment Scale (MAAS), and the Prenatal Self-Evaluation Questionnaire (PSEQ) to assess adaptation to pregnancy.

FINDINGS

Pregnant women were exposed to low level of violence (Mean ± SD: 64.42 ± 5.30). A statistically significant positive correlation was found between their DVAWS and PSEQ mean scores. There was also a statistically significant positive correlation between their DVAWS and MAAS mean scores.

PRACTICE IMPLICATIONS

Findings show that as domestic violence against women increased, adaptation to pregnancy decreased and maternal-fetal attachment increased.

Landscaping the evidence of intimate partner violence and postpartum depression: a systematic review

OBJECTIVE

To assess the evidence of the association between exposure to intimate partner violence (IPV) and postpartum depression. IPV during pregnancy can have immediate and long-term physical and mental health consequences for the family. Therefore, it has been hypothesised that IPV may affect the risk of developing postpartum depression.

METHODS

A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Embase, Global Health Library, Scopus and Google scholar were searched for published studies without restrictions on language, time or study design (up to May 2020). Studies were included if they assessed postpartum depression using the Edinburg Postnatal Depression Scale (cut-off≥10), among women who had been exposed to IPV (emotional, physical and/or sexual abuse). The quality of studies was judged according to the Newcastle-Ottawa scale.

RESULTS

A total of 33 studies were included in the review (participants n=131 131). The majority of studies found an association between exposure to IPV and the development of signs of postpartum depression. Overall, studies measured both exposure and outcome in various ways and controlled for a vast number of different confounders. Thirty percent of the studies were set in low-income and lower-middle-income countries while the rest were set in upper-middle-income and high-income countries and the association did not differ across settings. Among the studies reporting adjusted OR (aOR) (n=26), the significant aOR ranged between 1.18 and 6.87 (95% CI 1.12 to 11.78). The majority of the studies were judged as 'good quality' (n=20/33).

CONCLUSION

We found evidence of an association between exposure to IPV and the development of signs of postpartum depression. Meta-analysis or individual patient data meta-analysis is required to quantify the magnitude of the association between IPV and postpartum depression.

PROSPERO REGISTRATION NUMBER

CRD42020209435.

Factors associated with preterm birth among mothers who gave birth at public Hospitals in Sidama regional state, Southeast Ethiopia: Unmatched case-control study

BACKGROUND

Preterm birth remains the commonest cause of neonatal mortality, and morbidity representing one of the principal targets of neonatal health care. Ethiopia is one of the countries which shoulder the highest burden of preterm birth. Therefore, this study was aimed to assess factors associated with preterm birth at public hospitals in Sidama regional state.

METHODS

Facility-based case-control study was conducted at public hospitals in Sidama regional state, from 1st June to 1st September/2020. In this study, a total of 135 cases and 270 controls have participated. To recruit cases and controls consecutive sampling methods and simple random sampling techniques were used respectively. Data were collected using pretested structured interviewer-administered questionnaire, and checklist via chart review. Data were entered using EpiData version 3.1 and exported to SPSS version 20 for analysis. Independent variables with P-value < 0.25 in the bivariate logistic regression were candidates for multivariable logistic regression analysis. Finally, statistical significance was declared at P-value < 0.05.

RESULTS

The response rate was 100%. Rural resident (AOR = 2.034; 95%CI: 1.242, 3.331), no antenatal care service utilization (AOR = 2.516; 95%CI: 1.406, 4.503), pregnancy-induced hypertension (AOR = 2.870; 95%CI: 1.519, 5.424), chronic medical problem during pregnancy (AOR = 2.507; 95%CI: 1.345, 4.676), urinary tract infections (AOR = 3.023; 95%CI: 1.657, 5.513), birth space less than 2 years (AOR = 3.029; 95%CI: 1.484, 6.179), and physical intimate violence (AOR = 2.876; 95%CI: 1.534, 5.393) were significantly associated with preterm birth.

CONCLUSION

Most of the risk factors of preterm birth were found to be modifiable. Community mobilization on physical violence during pregnancy and antenatal care follow-up are the ground for the prevention of preterm birth because attentive and critical antenatal care screening practice could early identify risk factors. Besides, information communication education about preterm birth prevention was recommended.

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

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.

Anxiety and depressive symptoms in pregnancy predict low birth weight differentially in male and female infants-findings from an urban pregnancy cohort in India

PURPOSE

This study examined the contributions of antenatal anxiety, depression, and partner violence to low birth weight (LBW) in infants and to sex-specific birth weight outcomes among mothers from a cohort in urban India.

METHODS

Data from 700 mothers from the PRAMMS cohort (Prospective Assessment of Maternal Mental Health Study) were used. Pregnant women were assessed in each trimester-T1, T2 and T3, for symptoms of anxiety, and depression as well as partner violence. Multivariate analyses were performed for the whole sample and then for male and female infants separately. The final multivariable logistic regression models were each built using a backward selection procedure and controlling for confounders. To accommodate longitudinally measured data, change in scores (T2-T1 and T3-T2) of anxiety and depression were included in the model.

RESULTS

Of the 583 women with a singleton live birth, birth weight was available for 514 infants  and LBW was recorded in 80 infants (15.6%). Of these, 23 infants were preterm. Overall, higher T1 Depression scores (OR: 1.11; 95% CI 1.040, 1.187) and an increase in both Depression scores (OR: 1.12; 95% CI 1.047, 1.195) from T1 to T2 and Anxiety scores (OR: 1.32; 95% CI 1.079, 1.603) between T2 and T3 were predictors of LBW. Female infants had a higher chance of LBW with increase in maternal anxiety between T1-T2 (OR: 1.69; 95% CI 1.053, 2.708) and T2-T3 (OR: 1.49; 95% CI 1.058, 2.086); partner violence during pregnancy just failed to reach conventional statistical significance (OR: 2.48; 95% CI 0.810, 7.581) in girls. Male infants had a higher chance of LBW with higher baseline depression scores at T1 (OR: 1.23; 95% CI 1.042, 1.452) and an increase in depression scores (OR: 1.25; 95% CI 1.060, 1.472) from T1 to T2.

CONCLUSION

Increasing prenatal anxiety and depressive symptoms in different trimesters of pregnancy were associated with LBW with sex-specific patterns of association in this sample from a Low and Middle Income Country.

Associations of forms of intimate partner violence with low birth weight in India: findings from a population-based Survey

BACKGROUND

Many studies report a significant association between a lifetime measure of intimate partner violence (IPV) and low birth weight (LBW) in low-income and economically developed countries. However, it remains relatively unclear how different forms of IPV affect LBW in low-income countries. This study examines the associations of various forms of IPV with two measures of birth outcomes - LBW and birth weight in India.

METHODS

This study used the National Family Health Survey (NFHS-4) 2015-2016 data of India. The analysis included 11,423 women aged 15-49 years. Using both logistic and linear regression analyses, we assessed the associations of various forms of IPV with binary and continuous measures of birth weight. The analysis controlled for several potential covariates.

RESULTS

In fully-adjusted regression models, women who experienced any IPV, compared to those who had not experienced any IPV, were 1.19 times (95% CI: 1.02-1.37) as likely to give birth to an LBW baby. Compared to those who had not experienced any physical violence (PV), women who experienced any PV were 1.16 times (95% CI: 1.00-1.35) as likely to have an LBW baby. Moreover, compared to those who had not experienced any emotional violence (EV), women who experienced any EV were 1.29 times (95% CI: 1.06-1.56) as likely to have LBW babies. Linear regression analysis found that any IPV exposure was associated with a significant decrease in birth weight in the fully-adjusted model (b = -32.39; 95% CI: -63.39 to -1.73). Further, experience of any PV (b = -28.40; 95% CI: -60.13 to 3.36) and any EV (b = -51.69; 95% CI: -93.97 to -9.42) appear to be negatively associated with a continuous measure of birth weight.

CONCLUSION

Findings have implications for public health policies and interventions that protect women from exposure to intimate partner violence for ensuring better maternal health and birth outcomes.

Intimate partner violence during pregnancy in Vietnam: role of husbands

Intimate partner violence (IPV) perpetrators are often husbands. Understanding factors pertaining to women's male partners is essential for programming interventions against IPV. The objective of the study was to describe husband-related social and behavioural risk factors and assess how they are associated with IPV during pregnancy. Cross-sectional data were collected among 1309 pregnant women with husbands in Dong Anh district, Vietnam. Information on sociodemographic characteristics of husbands, the husband's behaviour and the husband's involvement in pregnancy care was indirectly collected via women's report at first antenatal care visit. Data on exposure to intimate partner violence during pregnancy were collected when the women returned for antenatal care in 30-34 gestational weeks. Logistic regression analyses were used to measure the relationships between IPV during pregnancy and risk factors from the husband. Pregnant women who had husbands who were younger or blue-collar worker/farmer/unemployed had more likelihood to be exposed to IPV. Women with husbands who drank alcohol before sexual intercourse and gambled were more likely to be exposed to IPV repeated times. Those with husbands who had intentions of having a child had over three times increased OR to be exposed to IPV once (AOR = 3.2, 95% CI 1.1-9.7). If the husband had a preference for sons, the woman had 1.5 times increased OR (AOR = 1.5; 95% CI 1.1-1.9) to be exposed to IPV repeated times during pregnancy. This study highlights significant associations between IPV and maternal perceptions of husbands' behaviours and involvement in pregnancy. Findings may help to identify at-risk pregnant women to IPV and guide the development of targeted interventions to prevent IPV from husbands.

Intimate partner violence against pregnant women: sociodemographic profile and characteristics of the aggressions

ABSTRACT Objective: To identify the sociodemographic profile and the main characteristics of violence by intimate partners in pregnant women in São Paulo, Brazil. Method: Cross-sectional study based on notifications for suspected or confirmed cases of inter-police violence from the National Disease Notification System (SINAN) carried out in the 2016-2019 period. Collection was performed between March and June 2020. Chi-squared test or Fisher’s Exact test were used in statistical analysis. Results: A total of 4,269 notifications were obtained and the prevalent profile was women between 20 and 34 years old (62.5%), brown or black (51.3%), who have completed high school (22.5%) in the first trimester of pregnancy (44.2%). Physical violence was more frequent (48.3%), occurred at home (59.1%), motivated by sexism (22.29%). Sexual violence or rape was more frequent (85.4%) with abortion in cases provided for by law (39%). Conclusion: Adult brown or black women in the first gestational trimester experienced physical violence more frequently.

Intimate partner violence during pregnancy and risk of still birth in hospitals of Tigray region Ethiopia

BACKGROUND

Pregnancy may represent a time of exceptional vulnerability to intimate partner violence because of changes in women's conditions. Despite the fact that intimate partner violence during pregnancy confers considerable risk to the health of the woman and her fetus, data regarding to association of stillbirth and intimate partner violence is lacking in Tigray region. The objective of this study is to assess intimate partner violence during pregnancy and its association with still birth among postpartum mothers in hospitals in Tigray Region of Ethiopia.

METHODS

Cross-sectional study design was used to assess 648 women about intimate partner violence during pregnancy and its association with still birth. Simple random sampling technique was employed to select health facilities and systematic sampling was used to select the study participants. Data was entered by using Epi info version 3.5.1 and analyzed using SPSS version 20. Logistic regression analysis was done to assess the association between exposure to intimate partner violence during pregnancy and stillbirth while adjusting for possible confounders.

RESULTS

The prevalence of still birth was 3.6%in this study population. There was a statistically significant association between exposure to intimate partner violence during pregnancy and still birth. Pregnant women who were exposed to intimate partner violence during pregnancy were three times more likely to have still birth 3.3(95% CI: 1.1-9.7) as compared to those who were not exposed. Another important factor associated with stillbirth was low birthweight 16.7(95% CI,6-46).

CONCLUSIONS

The prevalence of still birth in this study was high. Women who subjected to intimate partner violence during pregnancy had greater risk of having stillbirth baby.

The Influence of Intimate Partner Violence on Pregnancy Symptoms

The current literature contains few studies conducted on the effects of intimate partner violence (IPV) on pregnancy symptoms. Does being subjected to IPV during pregnancy increase the incidence of pregnancy-related symptoms? The aim of the present study was to explore the impact of IPV on pregnancy-related symptoms. The study was conducted as comparative, descriptive, and cross-sectional research with a total of 370 participants. Data were collected using the Domestic Violence Against Women Screening Form, the Pregnancy Symptoms Inventory (PSI), and a descriptive questionnaire. The types of IPV the women in the study had experienced during pregnancy were, in order of frequency, verbal abuse (31.1 %; n = 115), economic abuse (25.9 %; n = 96), physical violence (8.4 %; n = 31), and sexual abuse (5.9%; n = 22). The PSI scores for the pregnant women subjected to physical violence related to gastrointestinal system symptoms (p < .05), cardiovascular system symptoms (p < .05), mental health symptoms (p = 0), neurological system symptoms (p < .05), urinary system symptoms (p < .01), and tiredness or fatigue (p = 0); their total PSI scores (p = 0) were significantly higher statistically than those of women who did not experience physical violence during pregnancy. The scores of the pregnant women subjected to sexual abuse related to mental health symptoms (p < .05), and their total PSI scores (p < .05) were significantly higher than those of women who did not experience sexual abuse. The scores of the pregnant women subjected to economic abuse related to tiredness or fatigue (p < .01) and their mental health symptom scores (p < .05) were significantly higher than those of women who did not experience economic abuse. Our results showed that women subjected to IPV during pregnancy experienced a higher incidence of pregnancy symptoms.

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.

Domestic violence and its association with pre-term or low birthweight delivery in Vietnam

Objective

To examine the association between various types of domestic violence (DV) during pregnancy (emotional violence, physical violence, and sexual violence) and pre-term or low birthweight delivery in women living in Ho Chi Minh city, Vietnam.

Methods

A cross-sectional study was conducted in ten districts of Ho Chi Minh city during the period of January 1, 2015–July 4, 2016, with 1,099 women aged 18–49 years old who had delivered at least one child within the past 2years and were living in Ho Chi Minh city.

Results

DV prevalence during pregnancy among women aged 18–49 years in Ho Chi Minh city was 23.4%. Emotional violence accounted for 16.8%; physical violence 7.3%, and sexual violence 12.4%. Results of multivariable logistic regression analysis showed that DV during pregnancy was associated with a 1.44-times increased risk of pre-term or/and low birthweight delivery (POR=1.44, 95% CI=1.04–1.99).

Conclusion

Domestic violence during pregnancy was associated with increased risk of pre-term/low birthweight delivery in Vietnamese women. These findings suggest the need for DV screening during antenatal care. Once DV is detected, the victims should be provided with counseling services and referred to available local support services so that they are provided with timely intervention.

Intimate partner violence and maternal depression during pregnancy: A community-based cross-sectional study in Ethiopia

Introduction

Intimate partner violence (IPV) is regarded an important public health and human rights issue, characterized by physical, sexual or emotional abuse. Globally more than one in three women report physical or sexual violence by their intimate partners. Though the association between IPV and depression is known, we found no study investigating depression as a risk factor for IPV and very few studies using standard tools in assessing both IPV and depression among pregnant women.

Aim

To measure the prevalence of IPV and depression during pregnancy and assess the association between IPV and depression and other determinants.

Methods

A community-based cross-sectional study was conducted among 589 pregnant women living in Wondo-Genet district, southern Ethiopia. IPV experience was assessed using a structured questionnaire of the World Health Organization (WHO), and maternal depression was measured by the Edinburgh Postnatal Depression Scale (EPDS). Descriptive statistics were computed and multivariable logistic regression was carried out to estimate risk and adjust for confounders.

Results

The overall prevalence of IPV was 21% (95% confidence interval [CI] = 18.1–24.7). After adjusting for potential confounders, increased risk of IPV remained among rural women (adjusted odds ratio[AOR] = 2.09; 95%CI = 1.06–4.09), women who had parental exposure to IPV (AOR = 14.00; 95%CI = 6.43–30.48), women whose pregnancy was not desired (AOR = 9.64; 95%CI = 3.44–27.03), women whose husbands used alcohol (AOR = 17.08; 95%CI = 3.83–76.19), women with depression (AOR = 4.71; 95%CI = 1.37–16.18) and women with low social support (AOR = 13.93; 95%CI = 6.98–27.77). The prevalence of antenatal depressive symptom (with EPDS score above 13) was 6.8% (95% CI 6.2–11.3). Increased risk of depression was found among women who had been exposed to IPV (AOR = 17.60; 95%CI = 6.18–50.10) and whose husbands use alcohol (AOR = 3.31; 95%CI = 1.33–8.24).

Conclusion

One in five pregnant women experienced IPV and it was strongly associated with depression. Screening for IPV and depression at antenatal visits with referral to relevant care and service is recommended.

Intimate partner violence during pregnancy in Vietnam: prevalence, risk factors and the role of social support

Background: Violence against women is a global public health problem. A better understanding of risk factors for intimate partner violence (IPV) exposure during pregnancy is important to develop interventions for supporting women being exposed to IPV.

Objective: The purpose of this study was to measure the prevalence of IPV during pregnancy and analyse how social support and various risk factors are associated with IPV.

Methods: A cross-sectional study conducted among 1309 pregnant women in Dong Anh district, Vietnam. Information about socio-economic conditions and previous exposure to IPV was collected when women attended antenatal care before the 24th gestational week. Information about social support information and exposure to IPV during pregnancy was collected in the 30^th-34^th gestational week. Multivariable regression was used to identify associations between IPV, social support and other potential risk factors.

Results: The prevalence of IPV exposure during pregnancy was 35.2% (Emotional violence: 32.2%; physical violence: 3.5% and sexual violence: 9.9%). There was a statistically significant association between previous IPV exposure, lack of social support and IPV exposure during pregnancy. After adjustment for socioeconomic characteristics, pregnant women who had previously been exposed to IPV were more likely to be exposed IPV at least one time (AOR = 6.3; 95% CI: 4.9–8.2) as well as multiple times (AOR = 6.0; 95% CI: 4.5–8.0). Similarly, pregnant women having a lack of social support had a higher likelihood of being exposed to IPV at least one time (AOR = 3.1; 95% CI: 2.4–3.9) or multiple times (AOR = 2.9; 95% CI: 2.2–3.8).

Conclusion: IPV is relatively high during pregnancy in Vietnam. Previous exposure to IPV and lack of social support is associated with increased risk of violence exposure among pregnant women in Vietnam.

Domestic violence and perinatal outcomes - a prospective cohort study from Nepal

Background

Domestic violence is one of the most common forms of violence against women. Domestic violence during pregnancy is associated with adverse perinatal and maternal outcomes. We aimed to assess whether domestic violence was associated with mode of delivery, low birthweight and preterm birth in two sites in Nepal.

Methods

In this prospective cohort study we consecutively recruited 2004 pregnant women during antenatal care at two hospitals between June 2015 and September 2016. The Abuse Assessment Screen (modified) was used to assess fear and violence. Having ever experienced either fear or violence was defined as any domestic violence. Obstetric outcomes were obtained from hospital records for 1381 (69%) women, selecting singleton pregnancies only. Mode of delivery was assessed as birth by cesarean section or not. A birthweight of less than 2500 g was defined as low birthweight and preterm birth as birth before completion of 37 weeks gestation. Descriptive and multiple logistic regression analyses were performed to assess associations.

Results

Twenty percent of the women reported any domestic violence. Among all 1381 women, 37.6% gave birth by cesarean section. Of those women who delivered by cesarean section, 84.7% had an emergency cesarean section. Less than 10% of the babies were born prematurely and 13.5% were born with low birthweight. We found no significant association between exposure to any domestic violence during pregnancy and risk of a low birthweight baby or birth by cesarean section. However, having experienced both violence and fear was significantly associated with giving birth to a preterm infant [aOR 2.33 (95% CI;1.10–4.73)].

Conclusions

Domestic violence is common in Nepal. This is a potential risk factor for severe morbidity and mortality in newborns. We found that the risk of having a preterm baby was higher for pregnant women who experienced both fear and violence. This should be recognized by the health sector. In this study, no significant differences were found in the rate of cesarean section nor low birthweight for women who had experienced any domestic violence compared to those who did not.

Electronic supplementary material

The online version of this article (10.1186/s12889-019-6967-y) contains supplementary material, which is available to authorized users.

Factors Influencing Marital Violence Among Vietnamese Women in Taiwan

Introduction: Marital violence is a global women's health issue. This study aimed to examine the factors influencing marital violence among Vietnamese immigrant women in Taiwan. Method: A cross-sectional research design was used. Snowball sampling was applied to recruit 250 Vietnamese women in southeast Taiwan. Data were collected through a survey from August 2015 to January 2016. The data were analyzed using a regression analysis. Results: This study found that 70.4% of Vietnamese women had experienced marital violence in the past year. Participants who did not depend on their husband's income and held stronger views objecting to marital violence experienced a higher frequency of violence inflicted by their spouses. Conclusions/Implications: The study findings provide preliminary insight for nurses and a better understanding of the situation. They can be used not only to address the factors of marital violence affecting Vietnamese women in Taiwan but also to design marital violence-related interventions within a male-dominated culture.

Intimate partner violence during pregnancy and adverse birth outcomes: a case-control study

BACKGROUND

Intimate partner violence is a common phenomenon in Ethiopia families. About 81% of women believed that a husband is justified in beating his wife. About 30-60% of families were affected by their intimates. Women suffer physical, emotional, sexual and economic violence by their intimate partners. It often remains either for the sake of family secrecy, cultural norms or, due to fear, shame and community's reluctance on domestic affair and social stigma.The objective of this study is to examine the association between intimate partner violence during pregnancy and adverse birth outcomes.

METHODS

A hospital based unmatched case control study was conducted in four zonal hospitals of Tigray region. A total of 954 study participants (318 cases and 636 controls) were taken. Systematic sampling was used to select the cases and controls. Ethical clearance was obtained throughout the study period.

RESULT

Out of 954 interviewed mothers, 389 (40.8%) had experienced intimate partner violence during their index pregnancy period. More than two third (68.6%) of cases had been exposed to intimate partner violence. Multivariable logistic regression analysis showed that, women exposed to intimate partner violence during pregnancy were three times more likely to experience low birth weight (AOR = 3.1; CI 95% [1.470,6.618]) and preterm birth (AOR = 2.5; CI 95% [2.198-2.957]). It was observed that women who had been exposed to physical violence during pregnancy were five times more likely to experience low birth weight (AOR = 4.767; CI 95% [2.515, 9.034]) and preterm birth (AOR = 5.3; CI 95%: 3.95-7.094).

CONCLUSION AND RECOMMENDATION

It was found that the risk of preterm birth and low birth weight was increased when the pregnant women were exposed to more than one type of intimate partner violence and physical violence during pregnancy. Therefore, Efforts to address maternal and newborn health need to include issues of violence against women.

Association of intimate partner violence during pregnancy, prenatal depression, and adverse birth outcomes in Wuhan, China

Background

Intimate partner violence (IPV) among pregnant women constitutes a global public health problem and a potential risk factor for adverse maternal and fetal outcomes. The present study aimed to examine the associations among IPV during pregnancy, prenatal depression, and adverse birth outcomes in Wuhan, China.

Methods

A cross-sectional study was performed from April 2013 to March 2014 in Wuhan, China. Sociodemographic characteristics, IPV during pregnancy, and depressive symptoms during pregnancy were assessed in the third trimester of pregnancy. Birth outcomes were collected after delivery using medical records. Chi-square tests and logistic regression analysis were used to examine the association between IPV and prenatal depression, as well as the association between IPV combined with prenatal depression and adverse birth outcomes.

Results

After adjustment for covariates, there was a statistically significant association between IPV during pregnancy and prenatal depression (adjusted odds ratio [aOR] = 2.50, 95% confidence interval [CI]: 1.60–3.90). IPV during pregnancy (aOR = 1.67, 95% CI: 1.08–2.56) and prenatal depression (aOR = 1.72, 95% CI: 1.11–2.68) were significantly associated with adverse birth outcomes. Women experiencing psychological abuse had a significantly higher odds of prenatal depression (aOR = 2.04, 95% CI: 1.19–3.49) and of adverse birth outcomes (aOR = 2.13, 95% CI: 1.08–2.58), compared with women who did not experience IPV and prenatal depression.

Conclusions

IPV during pregnancy and prenatal depression were significantly associated with adverse birth outcomes, after adjustment for socio-demographic and behavior factors. The findings suggest that early recognition of IPV and prenatal depression during antenatal care may protect pregnant women and improve birth outcomes.

Emotional violence exerted by intimate partners and postnatal depressive symptoms among women in Vietnam: A prospective cohort study

BACKGROUND

Previous studies have shown a relation between intimate partner violence (IPV) and postpartum depression (PPD). However, these studies have primarily focused on physical and sexual violence as predictors for postpartum depression and little attention has been given to emotional violence (EV), despite emotional violence having been well reported as the most common type of violence experienced by women. This present study aimed to investigate the association between various types of emotional experience during life with present partner and postnatal depressive symptoms among women in Vietnam.

METHODS

A total of 1,274 pregnant women were recruited from 24 communities in the Dong Anh District, Hanoi, Vietnam. They were interviewed four times: (a) at enrolment (before week 24 of pregnancy); (b) at a gestational age of 30-34 weeks; (c) 24-48 hours after delivery; and (d) 4-12 weeks after delivery. Emotional violence and postnatal depressive symptoms were measured using a questionnaire developed by the World Health Organization (WHO) and the Edinburgh Postpartum Depression Scale (EPDS), respectively.

RESULTS

A total of 639 (50.4%) women experienced at least one type of emotional violence with their present partner, whereas 104 women (8.2%) experienced postnatal depressive symptoms. Women exposed to emotional violence were more likely to experience postnatal depressive symptoms (OR = 3.15; 95%CI: 1.17-8.51). Other statistically significant predictors of increased postnatal depressive symptoms included type of employment, lack of family support after delivery, lower level of education, husband's preference for a specific sex of child, presence of mental disorder, and depression during pregnancy.

CONCLUSIONS

Among Vietnamese women, there was a statistically significant association between exposure to emotional violence with their present partner and postpartum depression. The findings indicate an urgent need for screening for all acts of emotional violence as risk factors for postnatal depressive symptoms.

"Staying for the children": The role of natal relatives in supporting women experiencing intimate partner violence during pregnancy in northern Tanzania - A qualitative study

INTRODUCTION

Intimate partner violence (IPV) is a global health and human rights problem. In Tanzania, national studies have shown that half of all women experience partner violence in their lifetime, 38% reported being abused during a period of 12 months and 30% during pregnancy. Despite the benefits of social support to women victims of violence during pregnancy, a majority of women hesitate to seek help and, if they do, they mainly turn to their natal relatives for support. However, this process of help-seeking and the type of support received is not well documented and needs to be explored with a view to future interventions. This article investigates women's own perspectives on the support they receive from natal relatives when experiencing IPV during pregnancy.

MATERIALS AND METHODS

Eighteen participants who experienced physical IPV during pregnancy were purposively selected from a cohort of 1,116 pregnant women enrolled in a project that aimed at assessing the impact of intimate partner violence on reproductive health. In-depth interviews were used to explore the social support received from the natal family among women who experienced partner violence during pregnancy. All interviews were audio recorded, transcribed, coded and analyzed.

RESULTS

Women who experienced severe IPV during pregnancy were more likely to seek help from natal relatives. Severe violence was defined by the women as acts that occurred frequently and/or resulted in injury. The women's natal relatives were willing to provide the support; however, they strongly encouraged women to maintain their marriage so that they could continue caring for their children jointly with their partners. Emotional support was the commonest form of support and included showing love and empathy and praying. Information provided to victims aimed mainly at advising them to maintain their marriage. Practical support included direct financial support and building their economic base to reduce dependency on their partners. When the couple was on the verge of separation, mediation was provided to save the marriage.

CONCLUSION

Women who experienced partner violence preferred to seek help from their natal relatives. The support provided by natal relatives was beneficial; however, maintaining the marriage for the care of children and family was given the highest priority, over separation. As a consequence, many women continued to live with violence. Stakeholders supporting victims of violence need to understand the priorities of victims of violence and structure intervention to address their needs.

Emotional violence and maternal mental health: a qualitative study among women in northern Vietnam

Background

Worldwide, intimate partner violence (IPV) during pregnancy is a pressing and prevalent public health problem. Existing research has found close associations between IPV and perinatal mental health, yet little is known about women’s own perceptions of these associations. This study aimed to explore Vietnamese women’s experiences of emotional partner violence and their perceptions of the implications of such violence for their mental health.

Methods

The data were collected through in-depth interviews with 20 women living in Hanoi, Vietnam who had reported exposure to emotional partner violence and attained high depression scores in a prospective cohort study. Ten women were pregnant and ten had recently given birth. The data were analysed by qualitative content analysis.

Results

The women described emotional partner violence as a major life stressor. Their accounts pointed to three particularly significant dimensions of emotional violence: being ignored by the husband; being denied support; and being exposed to controlling behaviours. These experiences affected the women’s sense of wellbeing profoundly, causing sadness and distress. The women’s accounts indicated that experiences of emotional violence were significantly shaped by dominant kinship arrangements: practices of patrilocal residence and principles of patrilineal descent tended to aggravate women’s vulnerabilities to partner violence.

Conclusions

This qualitative study from Vietnam documents close associations between emotional partner violence and perinatal distress, while also pointing to kinship arrangements as particularly significant structural contexts shaping women’s experiences of partner violence. The study findings suggest that effective policies and programs to decrease women’s vulnerability to intimate partner violence must take into account the kinship arrangements that prevail in a given society.

Intimate partner violence (IPV): The validity of an IPV screening instrument utilized among pregnant women in Tanzania and Vietnam

Background

Intimate partner violence (IPV) is a global problem that affects one-third of all women. The present study aims to develop and determine the validity of a screening instrument for the detection of IPV in pregnant women in Tanzania and Vietnam and to determine the minimum number of questions needed to identify IPV.

Method

An IPV screening instrument based on eight questions was tested on 1,116 Tanzanian and 1,309 Vietnamese women who attended antenatal care before 24 gestational weeks. The women were re-interviewed during their 30^th-34^th gestational week where the World Health Organization (WHO) IPV questionnaire was used as the gold standard. In all, 255 combinations of eight different questions were first tested on the Tanzanian study population where sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated. In the evaluation of the performance of the question combinations, different IPV types and the frequency of abusive acts were considered. The question combinations that performed best in Tanzania were subsequently evaluated in the Vietnamese study population.

Results

In Tanzania, a combination of three selected questions including one question on emotional IPV, one on physical IPV and one on sexual IPV was found to be most effective in identifying women who are exposed to at least one type of IPV during pregnancy (sensitivity = .80; specificity = .74). The performance of the identified combination was slightly less effective in Vietnam (sensitivity = .74; specificity = .68). Focusing on different IPV types, the best performance was found for exposure to physical IPV in both Tanzania (sensitivity = .93; specificity = .70) and Vietnam (sensitivity = .96; specificity = .55). In both countries, the sensitivity increased with the frequency of abuse whereas the specificity decreased.

Conclusion

By asking pregnant women three simple questions we were able to identify women who were exposed to IPV during pregnancy in two different countries. The question combination performed best in assessing physical IPV where it identified 93% and 96% of Vietnamese and Tanzanian women, respectively, who were exposed to physical IPV.

Intimate partner violence among postpartum women: associated factors

ABSTRACT Objective: To identify the profile and assess the self-esteem of postpartum women, to characterize their babies and partners, and to verify the association of these characteristics with the occurrence of intimate partner violence (IPV). Method: Cross-sectional study with 207 postpartum women assisted in a public clinic. Results: There was no statistic correlation among the sociodemographic variables, personal and obstetric characteristics with the occurrence of IPV. The postpartum women who showed low self-esteem presented a higher exposure risk to IPV (p<0.01; OR=2.01 and CI 95% [1.40-2.87]). The mothers of the babies that were born with low weight (less than 2,500 g) had almost twice the chances of suffering violence (p<0.05; OR=1.74 and CI 95% [1.00-3.03]). The women whose partners did not consume alcohol presented a lower probability to be exposed to IPV (p<0.05; OR=0.182 and CI 95% [0.03-0.93]). Conclusion: Women's low self-esteem, babies' inappropriate weight and consumption of alcohol by partners were correlated to the occurrence of IPV.

Social support and intimate partner violence during pregnancy among women attending antenatal care in Moshi Municipality, Northern Tanzania

BACKGROUND

Intimate Partner Violence (IPV) is a significant public health problem with negative health consequences for women and their pregnancies. While social support has a protective effect against IPV and reduces health consequences of violence, its association with experiencing IPV during pregnancy remain less explored. In our study we aimed to determine the effect of social support on IPV during pregnancy among women attending antenatal care in Moshi, Tanzania METHODS: The study was part of a prospective cohort study that assessed the impact of violence on reproductive health of 1,116 participants. Pregnant women were enrolled below 24 weeks of gestation and followed until delivery. The experiences of social support and IPV during pregnancy were assessed at the 34th week of gestation. Logistic regression analysis was performed to assess the relationship between social support and IPV, with adjustment for potential confounders.

RESULTS

The prevalence of IPV during pregnancy was 30.3% where the majority (29.0%) experienced repeated episodes of abuse. Regarding practical social support, having no one to help financially was associated with increased odds of IPV and repeated episodes of abuse during pregnancy, AOR 3.57, (95% CI 1.85 - 6.90) and AOR 3.21, (95% CI 1.69 - 6.11) respectively. For social support in terms of communication, talking to a member of the family of origin at least monthly was associated with decreased odds of IPV and repeated episodes of IPV during pregnancy, AOR 0.46 (95% CI 0.26 - 0.82) and AOR 0.41 (95% CI 0.23 - 0.73) respectively. Perceiving that family of origin will not offer support was associated with a increased odds of IPV and repeated episodes of IPV, AOR 2.29, (95% CI 1.31 - 3.99) and AOR 2.14, (95% CI 1.23 - 3.74) respectively.

CONCLUSIONS

Nearly one third of women experienced IPV during pregnancy. Social support to women is associated with decreased odds of experiencing IPV during pregnancy. The family of origin plays an important role in providing social support to women who experience abuse during pregnancy; however, their true involvement in mitigating the impact of violence in the African setting needs further research.