Prevalence, Risk Factors and Effects of Domestic Violence Before and During Pregnancy on Birth Outcomes: An Observational Study of Literate Omani Women

Perturbations in risk/reward decision making and frontal cortical catecholamine regulation induced by mild traumatic brain injury

Mild traumatic brain injury (mTBI) disrupts cognitive processes that influence risk taking behavior. Little is known regarding the effects of repetitive mild injury (rmTBI) or whether these outcomes are sex specific. Risk/reward decision making is mediated by the prefrontal cortex (PFC), which is densely innervated by catecholaminergic fibers. Aberrant PFC catecholamine activity has been documented following TBI and may underlie TBI-induced risky behavior. The present study characterized the effects of rmTBI on risk/reward decision making behavior and catecholamine transmitter regulatory proteins within the PFC. Rats were exposed to sham, single (smTBI), or three closed-head controlled cortical impact (CH-CCI) injuries and assessed for injury-induced effects on risk/reward decision making using a probabilistic discounting task (PDT). In the first week post-final surgery, mTBI increased risky choice preference. By the fourth week, males exhibited increased latencies to make risky choices following rmTBI, demonstrating a delayed effect on processing speed. When levels of tyrosine hydroxylase (TH) and the norepinephrine reuptake transporter (NET) were measured within subregions of the PFC, females exhibited dramatic increases of TH levels within the orbitofrontal cortex (OFC) following smTBI. However, both males and females demonstrated reduced levels of OFC NET following rmTBI. These results indicate the OFC is susceptible to catecholamine instability after rmTBI and suggests that not all areas of the PFC contribute equally to TBI-induced imbalances. Overall, the CH-CCI model of rmTBI has revealed time-dependent and sex-specific changes in risk/reward decision making and catecholamine regulation following repetitive mild head injuries.

Domestic Violence in Pregnancy during the Pandemic Era: a Systematic Review

INTRODUCTION

Women, and mainly pregnant ones, have been always highly vulnerable to domestic violence/intimate partner violence (DV/IPV) throughout their lives. Covid-19 pandemic brought new unprecedented living conditions that raised the rates of DV during pregnancy. Investigating the association between Covid-19 and DV in pregnant women may help government and community groups seeking to reduce DV/IPV in vulnerable populations in order to better understand the prevalence of this phenomenon and its associated factors and thus find ways to ensure control and stop domestic violence, as the society and health care systems are still disorganized in the way they deal with the DV against pregnant women.

AIM

The aim of this study is to investigate the state of DV in pregnant women during the Covid-19 pandemic and to present the incidence rates of domestic violence as well as the possible consequences that can occur for both women and newborns, while also highlighting risk factors connected to Covid-19 that increase DV and attempting to see if there is a way to prevent and address DV through a systematic review of the available literature.

METHODS

We searched Google Scholar, Medline and PubMed for relevant articles published between 2019-2023. Out of the total number of 772 returned articles, only 25 were included in the present review after excluding all those which failed to meet one of the critical criteria.

RESULTS

We identified four themes linked to DV during pregnancy in the pandemic era, including the incidence of negative consequences for mother and fetus, Covid-19-associated factors, interventions and solutions. Also, prevalence of DV was found to be higher than before the pandemic. DV/IPV was linked to Covid-19 factors such as lockdown and quarantine, causing spouses to spend more time together, economic strains from loss of incomes and reduced incomes, unintended pregnancies and limited access to healthcare services for antenatal and prenatal clinics and support. The adverse effects of DV/IPV on pregnant women and the fetus include miscarriages, still births, abortions, early fetal loss, maternal anxiety and depression as well as poor development of the child after birth, among others. Critical interventions to manage DV/IPV during the pandemic include, to name just a few, better screening systems during the pandemic, public awareness, maintenance of support and healthcare systems and connections.

CONCLUSIONS

Covid-19 created circumstances and measures that increased the risk and incidence of DV/IPV in pregnant women, which led to a higher prevalence of the phenomenon. Sustainable systems can help reduce DV/IPV against women and, in particular women at-risk, such as pregnant ones. Therefore, some interventions, including screening mechanisms and public awareness, healthcare support and interconnections, need to be maintained and strengthened during times of crisis, such as the pandemic, to curb mitigate DV/IPV.

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/.