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Schellhammer SK, Starnes JR, Mudhune S, Goore L, Marlar L, Oyugi S, Wamae J, Shumba CS, Rogers A, Mbeya J, Vill B, Otieno AS, Wamai RG, Were LPO. Interpersonal violence against women and maternity care in Migori County, Kenya: evidence from a cross-sectional survey. Front Glob Womens Health 2024; 5:1345153. [PMID: 38784942 PMCID: PMC11111867 DOI: 10.3389/fgwh.2024.1345153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 04/17/2024] [Indexed: 05/25/2024] Open
Abstract
Background Interpersonal violence (IPV) is an issue of major public health concern, with 24% of Kenyan women reporting physical violence perpetrated by a current husband or partner. IPV has profound impacts on physical and mental health outcomes, particularly for pregnant women; it has been found to increase the risk of perinatal mortality, low birth weight, and preterm birth. This study aims to identify variables associated with IPV and assess the effects of IPV experience on prenatal and peripartum maternal healthcare in Migori County, Kenya. Findings build on a previous study that investigated a smaller region of Migori County. Methods Responses to cross-sectional household surveys conducted in six wards of Migori County, Kenya in 2021 from female respondents aged 18 and older were analyzed. The survey contained validated screening tools for interpersonal violence. Group-wise comparisons, and bivariate and multivariate logistic regression analyses were performed to describe community prevalence, factors associated with IPV against women, and the effect of IPV exposure on prenatal and peripartum health care. Results This study finds that 2,306 (36.7%) of the 6,290 respondents had experienced lifetime IPV. IPV experience was associated with the age group 25-49 (adjusted odds ratio (aOR) 1.208; 95%CI: [1.045-1.397]; p = 0.011), monogamous marriage [aOR 2.152; 95%CI: (1.426-3.248); p < 0.001], polygamous marriage [aOR 2.924; 95%CI: (1.826-4.683); p < 0.001], being widowed/divorced/separated [aOR 1.745; 95%CI: (1.094-2.786); p < 0.001], feeling an attitude of "sometimes okay" toward wife beating [aOR 2.002 95%CI: (1.651, 2.428); p < 0.001], having been exposed to IPV in girlhood [aOR 2.525; 95%CI: (2.202-2.896); p < 0.001] and feeling safe in the current relationship [aOR 0.722; 95%CI: (0.609, 0.855); p < 0.001]. A depression score of mild [aOR 1.482; 95%CI: (1.269, 1.73); p < 0.001] and severe [aOR 2.403; 95%CI: (1.429, 4.039); p = 0.001] was also associated with IPV experience, and women who experienced emotional abuse were much more likely to have experienced IPV [aOR 10.462; 95% CI: (9.037, 12.112); p < 0.001]. Adjusted analyses showed that having experienced IPV was negatively associated with attending at least four antenatal care visits during the most recent pregnancy (OR 0.849, p = 0.044) and with having a skilled birth attendant (OR 0.638, p = 0.007). Conclusions IPV is prevalent in Migori County, Kenya, with increased prevalence among women aged 25-49, those residing in West Kanyamkago, those in a monogamous or polygamous marriage, those who have been widowed/divorced/separated, and those with severe depressive symptoms. Further, IPV exposure is associated with lower use of maternal care services and may lead to worse maternal health outcomes. There is need for enhanced effort in addressing social and gender norms that perpetuate IPV, and this study can contribute to guiding policy interventions and community responses towards IPV.
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Affiliation(s)
| | - Joseph R. Starnes
- Department of Pediatrics, Division of Pediatric Cardiology, Vanderbilt University School of Medicine, Nashville, TN, United States
- Lwala Community Alliance, Rongo, Kenya
| | | | - Lou Goore
- Lwala Community Alliance, Rongo, Kenya
| | | | | | | | - Constance S. Shumba
- Division of Epidemiology and Social Sciences, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, United States
| | | | | | - Beffy Vill
- Department of Health Services, Migori County, Kenya
| | | | - Richard G. Wamai
- Department of Cultures, Societies, and Global Studies, Northeastern University, Boston, MA, United States
| | - Lawrence P. O. Were
- Department of Health Sciences & Department of Global Health, Boston University, Boston, MA, United States
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Aliasghari F, Effati-Daryani F, Mohammadi A, Mirghafourvand M. Relationship of domestic violence with pregnancy symptoms and pregnancy experience in Iranian pregnant women: a cross-sectional study. BMJ Open 2024; 14:e082570. [PMID: 38670608 PMCID: PMC11057274 DOI: 10.1136/bmjopen-2023-082570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 04/17/2024] [Indexed: 04/28/2024] Open
Abstract
OBJECTIVE Violence has had adverse effects on the physical and psychological dimensions of pregnant women. This study was conducted with the aim of determining the relationship of domestic violence with pregnancy symptoms and pregnancy experience. DESIGN In this cross-sectional study, pregnant women were selected through two-stage cluster sampling method. Data were collected using the domestic violence questionnaire of the WHO, pregnancy symptoms inventory (PSI) and pregnancy experience scale (PES). To determine the relationship between domestic violence with pregnancy symptoms and pregnancy experience, adjusted general linear model was used in multivariate analysis. SETTING Health centres in Urmia-Iran in 2022. PARTICIPANTS 415 pregnant women. RESULTS The frequency of emotional, physical and sexual violence was 86.0%, 67.7% and 79.5%, respectively. The mean (SD) of PSI was 49.45 (14.38) with attainable score of 0-123 and PES including happiness and worry was 14.32 (6.48) and 16.21 (2.51) with attainable score of 0-30, respectively. Based on the adjusted general linear model, the mean score of PSI in women who experienced physical violence (mild (p<0.001) and moderate (p<0.001)); sexual violence (mild (p<0.001), moderate (p<0.001) and severe (p<0.001)); and emotional violence (mild (p<0.001), moderate (p=0.002) and severe (p<0.001)) was significantly higher than women without experiencing violence. The mean score of happiness during pregnancy in women who experienced physical violence (moderate (p=0.011)) and emotional violence (mild (p<0.001), moderate (p=0.002) and severe (p<0.001)) was significantly lower than women without experience of violence. Also, the mean score of worry scores in women with experience of sexual violence (mild (p=0.001) and moderate (p=0.012)) and emotional violence (mild (p<0.001), moderate (p<0.001)) and severe (p<0.001)) was significantly higher than women without experiencing violence. CONCLUSION Considering the relationship between violence and pregnancy symptoms and pregnancy experiences, it is necessary to use appropriate strategies to prevent violence in pregnant women.
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Affiliation(s)
- Fatemeh Aliasghari
- Nursing and Midwifery Faculty, Urmia University of Medical Sciences, Urmia, The Islamic Republic of Iran
| | - Fatemeh Effati-Daryani
- Midwifery Department, Urmia University of Medical Sciences, Urmia, The Islamic Republic of Iran
| | - Azam Mohammadi
- Iran University of Medical Sciences, Tehran, The Islamic Republic of Iran
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, The Islamic Republic of Iran
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Miller AP, Dean SS, Court L, Mvududu R, Mashele N, Wara NJ, Myer L, Shoptaw S, Davey DLJ. "So that's why I found PrEP to be safest way to protect yourself": exploring IPV experiences and impact on HIV prevention among pregnant and postpartum women in Cape Town, South Africa. BMC Public Health 2024; 24:481. [PMID: 38360616 PMCID: PMC10870618 DOI: 10.1186/s12889-024-17871-w] [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: 10/04/2023] [Accepted: 01/24/2024] [Indexed: 02/17/2024] Open
Abstract
Intimate partner violence (IPV) occurs at alarmingly high rates towards pregnant women in South Africa. Experiences of emotional, physical, and sexual IPV in pregnancy can adversely impact the health and safety of mother and fetus. Furthermore, IPV is associated with increased risk of HIV, exacerbating the public health impact of violence among pregnant women in this HIV endemic setting. In-depth understanding of cultural and contextual drivers of experiences of IPV is a critical precursor to development of interventions effectively addressing this issue among pregnant women in South Africa. The present study examines factors contributing to IPV among pregnant women to identify potential points of intervention. We conducted twenty in-depth interviews with postpartum women who used oral pre-exposure prophylaxis (PrEP) in pregnancy and reported recent experiences of IPV and/or ongoing alcohol use in a township near Cape Town, South Africa that experiences a heavy burden of both HIV and IPV. Interpretive thematic analysis was used. Several patterns of IPV during pregnancy were identified and violence was frequently described as co-occurring with male partner alcohol use. A majority of women referenced oral PrEP as their preferred method for HIV prevention, highlighting the agency and discretion it provided as beneficial attributes for women experiencing IPV. Fear of judgement from peers for remaining with an abusive partner and a lack of clear community messaging around IPV were identified as barriers to disclosure and support-seeking. Addressing the lack of social support received by women experiencing IPV during pregnancy in South Africa is essential to comprehensive IPV programming.
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Affiliation(s)
- Amanda P Miller
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, CA, USA.
| | - Sarah Schoetz Dean
- Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Lara Court
- Division of Socio-behavioural Sciences, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Rufaro Mvududu
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Nyiko Mashele
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Nafisa J Wara
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Landon Myer
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Steven Shoptaw
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Dvora L Joseph Davey
- Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
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Bolarinwa OA, Hajjar JM, Alawode OA, Ajayi KV, Roberts AT, Yaya S. Multiple high-risk fertility behaviours and children under five mortality survivors among ever-married women of reproductive age in Nigeria. Arch Public Health 2023; 81:175. [PMID: 37759256 PMCID: PMC10523755 DOI: 10.1186/s13690-023-01192-2] [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: 07/18/2023] [Accepted: 09/19/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Multiple high-risk fertility behaviours (MHRFBs), including maternal age < 18 or > 34 years old, a birth order 4+, and birth spacing < 24 months, can directly or indirectly affect survival outcomes among under-five children. There is a dearth of available information and data about these two phenomena in Nigeria. Thus, this study evaluates the prevalence of MHRFBs and examines the association between MHRFBs and under-five mortality survival (U5M) outcomes among ever-married women of reproductive age in Nigeria. METHODS This study used the recent secondary datasets from the Nigerian Demographic Health Surveys conducted in 2018, with a total sample size of 10,304 women of reproductive age. The outcome variable was MHRFBs. Multivariable logistic regression analysis was employed to examine the association between U5M and MHRFBs. Odds ratios with a p-value of less than 0.05 were considered significant. RESULTS It was found that among women who had MHRFBs, U5M was prevalent, particularly in young maternal age (< 18 years) and within short birth intervals (< 24 months). The adjusted odds ratio of the association between MHRFBs and U5M shows the experience of MHRFBs, in addition to other factors such as household wealth index, type of marriage, and sex of child, to be significant predictors for U5M. The odds were higher for U5M to occur among women who had experienced MHRFBs compared to those who have not had an experience of MHRFBs [aOR = 1.48; 95%CI: 1.02-2.17 ]. Similarly, the odds of U5M occurrence among women in polygamous marriages are higher compared to those in monogamous unions [aOR = 1.35; 95% CI: 1.10-1.65]. While under-five children born in the richest households (wealth quintiles) are less likely to die compared to those born in the poorest households [aOR = 0.64; 95% CI: 0.41-1.01]. CONCLUSION This study concludes that women in Nigeria who engaged in MHRFBs, particularly maternal ages < 18 years and short birth intervals (< 24 months), were more likely to experience U5M. Furthermore, children born to women who received post-natal care after delivery were more likely to survive U5M, as were children born to women with educated partners. We recommend strengthening educational opportunities and creating adaptive reproductive health education programs for ever-married women of reproductive age in Nigeria.
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Affiliation(s)
- Obasanjo Afolabi Bolarinwa
- Department of Public Health, York St. John University, London, UK.
- Department of Demography and Population Studies, University of Witwatersrand, Johannesburg, South Africa.
| | - Julia Marie Hajjar
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Oluwatobi Abel Alawode
- Department of Sociology and Criminology & Law, University of Florida, Gainesville, FL, 32611, USA
| | - Kobi V Ajayi
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, TX, USA
| | | | - Sanni Yaya
- School of International Development and Global Studies, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada
- The George Institute for Global Health, Imperial College London, London, UK
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Bagheri R, Farahani FK, Ebrahimi M. Domestic Violence and Its Impact on Abortion in Iran: Evidence From a Nationally Representative Survey. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:9492-9513. [PMID: 37102584 PMCID: PMC10668540 DOI: 10.1177/08862605231168824] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
The objective of this article is to assess the effect of domestic violence on abortion and investigate the mediating role of unwanted pregnancy. A secondary analysis was conducted on the National Family Survey data. This survey was a cross-sectional study conducted across Iran in 2018. The association between domestic violence and abortion was analyzed using the Partial Least Square-Structural Equation Model (PLS-SEM) with WarpPLS version 8.0. From among 1,544 married women (mean age 42.8 years) who participated in this survey, 27% (418 women) reported experiencing at-least one-lifetime of abortion. Overall, two in three women (67.3%) experienced at least one form of domestic violence. Almost half of the women with experience of abortion (49.3%) reported at least one unwanted pregnancy in their life course. The bivariate analysis showed a significant positive relationship between domestic violence and abortion, and there was a positive direct effect of domestic violence on unwanted pregnancy. Moreover, age had a negative direct and indirect effect on unwanted pregnancy and abortion. Although, the direct effect of domestic violence on abortion was not significant in the Structure Equation Model, a positive indirect effect of domestic violence on abortion through unwanted pregnancy was confirmed. The effect of unwanted pregnancy on abortion was particularly strong (β = .395, p < .01). These results have some implications for prevention of abortion through interventions against unwanted and unplanned pregnancy and domestic violence. This study makes a unique theoretical contribution to the literature through assessing the mediating role of unwanted pregnancy between domestic violence and abortion by using the SEM model.
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Mitrogiannis I, Evangelou E, Efthymiou A, Kanavos T, Birbas E, Makrydimas G, Papatheodorou S. Risk factors for preterm labor: An Umbrella Review of meta-analyses of observational studies. RESEARCH SQUARE 2023:rs.3.rs-2639005. [PMID: 36993288 PMCID: PMC10055511 DOI: 10.21203/rs.3.rs-2639005/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Preterm birth defined as delivery before 37 gestational weeks, is a leading cause of neonatal and infant morbidity and mortality. Understanding its multifactorial nature may improve prediction, prevention and the clinical management. We performed an umbrella review to summarize the evidence from meta-analyses of observational studies on risks factors associated with PTB, evaluate whether there are indications of biases in this literature and identify which of the previously reported associations are supported by robust evidence. We included 1511 primary studies providing data on 170 associations, covering a wide range of comorbid diseases, obstetric and medical history, drugs, exposure to environmental agents, infections and vaccines. Only seven risk factors provided robust evidence. The results from synthesis of observational studies suggests that sleep quality and mental health, risk factors with robust evidence should be routinely screened in clinical practice, should be tested in large randomized trial. Identification of risk factors with robust evidence will promote the development and training of prediction models that could improve public health, in a way that offers new perspectives in health professionals.
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Mishkin KE, Ahmed HM, Maqsood SS. Factors associated with experiencing lifetime intimate partner violence among pregnant displaced women living in refugee camps in Erbil, Iraq. Glob Public Health 2022; 17:3455-3464. [PMID: 35259066 DOI: 10.1080/17441692.2022.2048409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
According to the World Health Organization, intimate partner violence (IPV) affects 35% of women worldwide and 40% of pregnant women, often resulting in maternal and infant death and harm. Displaced persons are at higher risk of abuse compared to the general population. While few studies have explored IPV in Iraq, research from Erbil, Iraq showed nearly 60% of women reported experiencing IPV in their lifetime. No publications examining IPV among displaced women in Iraq exist. Considering the severe impacts of IPV in pregnancy and the associated risks for IPV among women in refugee camps, this paper presents the first analysis of prevalence and factors associated with lifetime IPV among displaced pregnant women in two Iraqi refugee camps. Thirteen percent of women reported experiencing any abuse and experiencing IPV was associated with receiving fewer years of schooling (p = 0.04), not having a private doctor (p = 0.002), attending the first prenatal visit during the third trimester (p = 0.03), feeling pressure to have a child (p = 0.003), knowing someone who was physically injured by their husband (p = 0.05), experiencing suicidal ideation (p = 0.02), and being worried about harming one's baby (p = 0.02). Policy and programme recommendations for screening and prevention of IPV in resource-limited settings are provided.
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Affiliation(s)
| | - Hamdia Mirkhan Ahmed
- College of Health Sciences, Center for Research and Women's Health, Hawler Medical University, Erbil, Iraq
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Nelson HD, Darney BG, Ahrens K, Burgess A, Jungbauer RM, Cantor A, Atchison C, Eden KB, Goueth R, Fu R. Associations of Unintended Pregnancy With Maternal and Infant Health Outcomes: A Systematic Review and Meta-analysis. JAMA 2022; 328:1714-1729. [PMID: 36318133 PMCID: PMC9627416 DOI: 10.1001/jama.2022.19097] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
IMPORTANCE Unintended pregnancy is common in the US and is associated with adverse maternal and infant health outcomes; however, estimates of these associations specific to current US populations are lacking. OBJECTIVE To evaluate associations of unintended pregnancy with maternal and infant health outcomes during pregnancy and post partum with studies relevant to current clinical practice and public health in the US. DATA SOURCES Cochrane Central Register of Controlled Trials and Database of Systematic Reviews, PsycINFO, SocINDEX, and MEDLINE databases (January 1, 2000, to June 15, 2022) and manual review of reference lists. STUDY SELECTION Epidemiologic studies relevant to US populations that compared key maternal and infant health outcomes for unintended vs intended pregnancies and met prespecified eligibility criteria were included after investigators' independent dual review of abstracts and full-text articles. DATA EXTRACTION AND SYNTHESIS Investigators abstracted data from publications on study methods, participant characteristics, settings, pregnancy intention, comparators, confounders, and outcomes; data were validated by a second investigator. Risk of bias was independently dual rated by investigators using criteria developed by the US Preventive Services Task Force. Results of studies controlling for confounders were combined by using a profile likelihood random-effects model. MAIN OUTCOMES AND MEASURES Prenatal depression, postpartum depression, maternal experience of interpersonal violence, preterm birth, and infant low birth weight. RESULTS Thirty-six studies (N = 524 522 participants) were included (14 cohort studies rated good or fair quality; 22 cross-sectional studies); 12 studies used large population-based data sources. Compared with intended pregnancy, unintended pregnancy was significantly associated with higher odds of depression during pregnancy (23.3% vs 13.9%; adjusted odds ratio [aOR], 1.59 [95% CI, 1.35-1.92]; I2 = 85.0%; 15 studies [n = 41 054]) and post partum (15.7% vs 9.6%; aOR, 1.51 [95% CI, 1.40-1.70]; I2 = 7.1%; 10 studies [n = 82 673]), interpersonal violence (14.6% vs 5.5%; aOR, 2.22 [95% CI, 1.41-2.91]; I2 = 64.1%; 5 studies [n = 42 306]), preterm birth (9.4% vs 7.7%; aOR, 1.21 [95% CI, 1.12-1.31]; I2 = 1.7%; 10 studies [n = 94 351]), and infant low birth weight (7.3% vs 5.2%; aOR, 1.09 [95% CI, 1.02-1.21]; I2 = 0.0%; 8 studies [n = 87 547]). Results were similar in sensitivity analyses based on controlling for history of depression for prenatal and postpartum depression and on study design and definition of unintended pregnancy for relevant outcomes. Studies provided limited sociodemographic data and measurement of confounders and outcomes varied. CONCLUSIONS AND RELEVANCE In this systematic review and meta-analysis of epidemiologic observational studies relevant to US populations, unintended pregnancy, compared with intended pregnancy, was significantly associated with adverse maternal and infant outcomes. TRIAL REGISTRATION PROSPERO Identifier: CRD42020192981.
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Affiliation(s)
- Heidi D. Nelson
- Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California
| | - Blair G. Darney
- Oregon Health & Science University, Portland
- Oregon Health & Science University/Portland State University School of Public Health, Portland
- Instituto Nacional de Salud Pública, Centro de Investigación en Salud Poblacional, Cuernavaca, México
| | - Katherine Ahrens
- Public Health Program of the Muskie School of Public Service, University of Southern Maine, Portland
| | - Amanda Burgess
- Public Health Program of the Muskie School of Public Service, University of Southern Maine, Portland
| | - Rebecca M. Jungbauer
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland
| | - Amy Cantor
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland
| | - Chandler Atchison
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland
| | - Karen B. Eden
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland
| | - Rose Goueth
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland
| | - Rongwei Fu
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland
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Wu F, Zhou L, Chen C, Lin W, Liu P, Huang W, Zhong C, Zhang M, Li Q, Chen Q, Wang YY. Association between intimate partner violence and prenatal anxiety and depression in pregnant women: a cross-sectional survey during the COVID-19 epidemic in Shenzhen, China. BMJ Open 2022; 12:e055333. [PMID: 35589360 PMCID: PMC9121109 DOI: 10.1136/bmjopen-2021-055333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES Intimate partner violence (IPV) against women remains a major global public health problem with harmful consequences for individuals and society. People's lifestyles have been greatly affected by the COVID-19 pandemic. This study investigated the prevalence of and relationship between IPV and anxiety and depression in pregnant Chinese women during the pandemic. DESIGN Cross-sectional study. SETTING This investigation was conducted in Shenzhen City, Guangdong Province, China from 15 September to 15 December 2020. PARTICIPANTS A total of 3434 pregnant women were screened with the Abuse Assessment Screen Questionnaire to evaluate IPV and General Anxiety Disorder and Patient Health Questionnaire to evaluate symptoms of anxiety and depression, respectively. Pregnant women with perinatal health records at Shenzhen District Maternity and Child Healthcare Hospitals who consented to participate were enrolled. Women with psychotic disorders such as schizophrenia, mania or substance dependence and pregnant women who refused to participate were excluded. Data were analysed with the χ2 test and by logistic regression analysis. RESULTS The prevalence of IPV among pregnant women was 2.2%. Mental violence was the most common type of violence (2.2%), followed by physical (0.6%) and sexual (0.7%) violence. The prevalence of anxiety and depression symptoms was 9.8% and 6.9%, respectively. After adjusting for covariates, there was a statistically significant association between IPV and prenatal anxiety (OR=4.207, 95% CI: 2.469 to 7.166) and depression (OR=3.864, 95% CI: 2.095 to 7.125). CONCLUSIONS IPV increased the risk of prenatal anxiety and depression in pregnant women in China during the COVID-19 pandemic. Efforts should be made by the government and civil society to promote long-lasting antenatal interventions to ensure the safety and protect the mental health of pregnant women.
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Affiliation(s)
- Fei Wu
- Department of Healthcare, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, Guangdong, China
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Lin Zhou
- Department of Information Technology, Shenzhen Centre for Disease Control and Prevention, Shenzhen, Guangdong, China
| | - Caiyun Chen
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Wei Lin
- Department of Healthcare, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, Guangdong, China
| | - Peiyi Liu
- Department of Healthcare, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, Guangdong, China
| | - Weikang Huang
- Department of Healthcare, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, Guangdong, China
| | - Chuyan Zhong
- Department of Healthcare, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, Guangdong, China
| | - Minyi Zhang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Qiushuang Li
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Qing Chen
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Yue-Yun Wang
- Department of Healthcare, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, Guangdong, China
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Hailemariam M, Zlotnick C, Taft A, Johnson JE. MOSAIC (MOthers’ AdvocateS In the Community) for pregnant women and mothers of children under 5 with experience of intimate partner violence: A pilot randomized trial study protocol. PLoS One 2022; 17:e0267679. [PMID: 35584181 PMCID: PMC9116623 DOI: 10.1371/journal.pone.0267679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 04/22/2022] [Indexed: 11/19/2022] Open
Abstract
Background Pregnancy and motherhood increase the risk for long-term exposure to physical, psychological and sexual intimate partner violence (IPV; sexual or physical violence by current or former partners). Pregnant women and mothers with children under 5 who have experienced IPV exhibit poor physical and mental health and obstetric outcomes. Depression and posttraumatic stress disorder (PTSD) are the two most common mental health consequences of IPV. There is good evidence that women with good social support have better mental health and IPV outcomes. Methods This study will develop MOthers’ AdvocateS In the Community (MOSAIC) Plus intervention for pregnant women and mothers with children under the age of 5. MOSAIC uses trained mentor mothers and has been found to reduce subsequent IPV. This study will blend the original MOSAIC intervention with principles of interpersonal psychotherapy (IPT) to address symptoms of depression, PTSD, and prevent subsequent risk of IPV. We will conduct a pilot randomized trial of the MOSAIC Plus intervention compared to the traditional MOSAIC intervention to determine its feasibility and acceptability. Study samples include focus groups (n = 36), open trial (n = 15), and a randomized pilot trial including 40 pregnant women and mothers with children under 5 who report current/recent of IPV and elevated symptoms of maternal depression and/or PTSD. The study’s primary outcome will be changes in maternal depressive and PTSD symptoms. Secondary outcomes will include reduction in subsequent IPV, improvement in functioning, changes in social support and effectiveness in obtaining resources. Discussion This is a formative study evaluating the feasibility and acceptability of a mentor mother intervention for pregnant women and mothers with children under 5. Promising results of this study will be used for a larger, fully-powered randomized trial evaluating the effectiveness of a mentor mother intervention in preventing subsequent IPV and reducing depressive and PTSD symptoms in this population.
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Affiliation(s)
- Maji Hailemariam
- Department of Obstetrics, Gynaecology and Reproductive Biology, Michigan State University, College of Human Medicine, East Lansing, MI, United States of America
- * E-mail:
| | - Caron Zlotnick
- Department of Psychiatry and Human Behavior, Brown University, Providence, RI, United States of America
- Department of Medicine at Women and Infants Hospital, Providence, RI, United States of America
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Angela Taft
- Judith Lumley Centre for Mother, Infant and Family Health Research, Latrobe University, Bundoora, Australia
| | - Jennifer E. Johnson
- Department of Obstetrics, Gynaecology and Reproductive Biology, Michigan State University, College of Human Medicine, East Lansing, MI, United States of America
- Division of Public Health, College of Human Medicine, Michigan State University, Flint, MI, United States of America
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Rozario SS, Gondwe T, Masho SW. Pre-Pregnancy Intimate Partner Violence and Short Interbirth Interval: The Role of Insurance Status. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:11260-11280. [PMID: 31920145 DOI: 10.1177/0886260519897325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Short interbirth interval (IBI) has serious adverse health consequences, yet has an estimated prevalence of 35% in the United States. Similarly, intimate partner violence (IPV) around time of pregnancy, experienced by approximately 5% of women, is associated with increased risk of poor pregnancy outcomes. IPV might compromise women's decision-making, contributing to unintended pregnancy and short IBI. This study examines the relationship between pre-pregnancy IPV and short IBI, and whether insurance status moderates this relationship among multiparous women who responded to the 2009-2011 Pregnancy Risk Assessment Monitoring System survey (N = 13,675). Pre-pregnancy IPV (yes; no), insurance status (Private insurance; Medicaid/public insurance; no insurance), and short IBI (yes; no) were examined. Insurance status was identified as an effect modifier (p = .03), and maternal age, maternal and paternal education, marital status, and drinking alcohol were identified as potential confounders. Multiple logistic regression analysis stratified by insurance status provided adjusted odds ratios (aOR) with corresponding 95% confidence intervals (CI). Overall, 4.6% of women reported IPV before pregnancy, and 48% had a short IBI. When stratified by insurance status, the odds of short IBI was about 3 times higher among women with no insurance and women on Medicaid/public insurance who reported IPV compared to women who did not report IPV (aOR = 3.36, 95% CI = [1.02, 8.02], and aOR = 2.50, 95% CI = [1.04, 5.92], respectively). There was no observed significant difference in the likelihood of short IBI by experience of IPV among privately insured women. Findings from this study strengthen the evidence that women who experience IPV before pregnancy are significantly more likely to have short IBI compared to women who do not experience pre-pregnancy IPV. Furthermore, the odds of short IBI is highest among women experiencing pre-pregnancy IPV who are uninsured or on Medicaid/public insurance.
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Affiliation(s)
- Sylvia S Rozario
- Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Tamala Gondwe
- Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Saba W Masho
- Virginia Commonwealth University School of Medicine, Richmond, VA, USA
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12
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Iqbal A, Burrin C, Aydin E, Beardsall K, Wong H, Austin T. Generation COVID-19 - Should the foetus be worried? Acta Paediatr 2021; 110:759-764. [PMID: 33253455 PMCID: PMC7753784 DOI: 10.1111/apa.15693] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 11/11/2020] [Accepted: 11/25/2020] [Indexed: 12/25/2022]
Abstract
Aim The aim of this narrative review was to evaluate the risks, both direct and indirect, to the foetus from the COVID‐19 pandemic. Methods Direct and indirect risks were defined as (a) vertical infection (congenital or intrapartum), (b) maternal infection and its sequelae, and (c) sources of maternal stress during lockdown, including social isolation and altered healthcare provision. Results Early studies suggest that vertical viral transmission is low; however, there may be an important effect of maternal infection on foetal growth and development. The impact of various degrees of lockdown on prospective mothers’ health, habits and healthcare provision is of concern. In particular, increased maternal stress has been shown to have a significant effect on foetal brain development increasing the risk of mental health, and cognitive and behavioural disorders in later life. Conclusion From the evidence available to date, direct risks to the foetus from the SARS‐CoV‐2 virus are low. Indirect effects of the pandemic, particularly resulting from the effect of maternal stress on the developing brain, can have lifelong detrimental impacts for this generation of children.
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Affiliation(s)
| | - Charlotte Burrin
- School of Clinical Medicine University of Cambridge Cambridge UK
| | - Ezra Aydin
- Department of Psychology University of Cambridge Cambridge UK
| | | | - Hilary Wong
- Department of Paediatrics University of Cambridge Cambridge UK
| | - Topun Austin
- Department of Paediatrics University of Cambridge Cambridge UK
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13
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Kefale B, Yalew M, Damtie Y, Arefaynie M, Adane B. Predictors of sexual violence among female students in higher education institutions in Ethiopia: A systematic review and meta-analysis. PLoS One 2021; 16:e0247386. [PMID: 33606841 PMCID: PMC7894927 DOI: 10.1371/journal.pone.0247386] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 02/06/2021] [Indexed: 11/18/2022] Open
Abstract
Background Sexual violence is a profound social and public health problem in Ethiopia. Female students in institutions of higher education are highly vulnerable to sexual violence. Different studies conducted on sexual violence at higher education institutions lack consistency and inclusiveness. Thus, this systematic review and meta-analysis were conducted to estimate the lifetime and twelve-month prevalence, and predictors of sexual violence among female students in institutions of higher education in Ethiopia. Methods This study used a systematic review and meta-analysis of studies conducted from January 1, 2000, to June 1, 2020, in Ethiopia. This review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Electronic databases including PubMed, Cochrane Library, Hinari, Google Scholar, CINAHL, and Global Health were searched using relevant search terms. Meta-analysis was performed using STATA 14 software. The I2 statistics and Egger’s test were used to assess heterogeneity and publication bias, respectively. Forest plots were used to present the prevalence and odds ratio (OR) with a 95% confidence interval (CI). Results This systematic review and meta-analysis included 10 studies, 5790 study participants. The pooled lifetime and twelve-month prevalence of sexual violence among female students in Ethiopia was 49.4% (95%CI: 37.87, 60.96) and 36.02% (95%CI: 26.42, 45.62) respectively. Rural residence (OR = 2.13;95%CI: 1.33, 3.42), alcohol drinking (OR = 2.03; 95%CI: 1.44, 2.87), and ever had a boyfriend (OR = 2.07; 95%CI: 1.32, 3.62) were factors associated with sexual violence. Conclusions The lifetime prevalence of sexual violence among female students in institutions of higher education in Ethiopia was high. Place of residence, alcohol drinking, and ever had a boyfriend were statistically significant factors of sexual violence. Life skill training and law enforcement are needed to control alcohol consumption. Additionally, more focused interventions should be done in rural settings. Registration This systematic review has been registered in the International Prospective Registry of Systematic Review (PROSPERO) with a specific registration number CRD42020155894.
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Affiliation(s)
- Bereket Kefale
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
- * E-mail:
| | - Melaku Yalew
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Yitayish Damtie
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Mastewal Arefaynie
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Bezawit Adane
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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Murray AL, Kaiser D, Valdebenito S, Hughes C, Baban A, Fernando AD, Madrid B, Ward CL, Osafo J, Dunne M, Sikander S, Walker S, Van Thang V, Tomlinson M, Eisner M. The Intergenerational Effects of Intimate Partner Violence in Pregnancy: Mediating Pathways and Implications for Prevention. TRAUMA, VIOLENCE & ABUSE 2020; 21:964-976. [PMID: 30514180 DOI: 10.1177/1524838018813563] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Prenatal intimate partner violence (P-IPV) can have significant adverse impacts on both mother and fetus. Existing P-IPV interventions focus on the safety of the mother and on reducing revictimization; yet expanding these to address the adverse impact on the fetus has considerable potential for preventing long-term negative developmental outcomes. In this review, we draw together evidence on major pathways linking exposure to P-IPV and child outcomes, arguing that these pathways represent potential targets to improve P-IPV intervention efforts. Using a narrative review of 112 articles, we discuss candidate pathways linking P-IPV to child outcomes, as well as their implications for intervention. Articles were identified via key word searches of social science and medical databases and by inspection of reference lists of the most relevant articles, including recent reviews and meta-analyses. Articles were included if they addressed issues relevant to understanding the effects of P-IPV on child outcomes via six core pathways: maternal stress and mental illness, maternal-fetal attachment, maternal substance use, maternal nutritional intake, maternal antenatal health-care utilization, and infection. We also included articles relevant for linking these pathways to P-IPV interventions. We conclude that developing comprehensive P-IPV interventions that target immediate risk to the mother as well as long-term child outcomes via the candidate mediating pathways identified have significant potential to help reduce the global burden of P-IPV.
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Affiliation(s)
- Aja Louise Murray
- Institute of Criminology, University of Cambridge, Cambridge, United Kingdom
| | - Daniela Kaiser
- Institute of Criminology, University of Cambridge, Cambridge, United Kingdom
| | - Sara Valdebenito
- Institute of Criminology, University of Cambridge, Cambridge, United Kingdom
| | - Claire Hughes
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
| | - Adriana Baban
- Department of Psychology, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Asvini D Fernando
- Department of Paediatrics, Faculty of Medicine, University of Kelaniya, Colombo, Sri Lanka
| | - Bernadette Madrid
- Child Protection Unit, University of the Philippines, Quezon City, Philippines
| | - Catherine L Ward
- Department of Psychology and Safety and Violence Initiative, University of Cape Town, Cape Town, South Africa
| | - Joseph Osafo
- Department of Psychology, University of Ghana, Accra, Ghana
| | - Michael Dunne
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | | | - Susan Walker
- Caribbean Institute for Health Research, The University of the West Indies, Kingston, Jamaica
| | - Vo Van Thang
- Faculty of Public Health, Hue University of Medicine and Pharmacy, Hue, Vietnam
| | - Mark Tomlinson
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Manuel Eisner
- Institute of Criminology, University of Cambridge, Cambridge, United Kingdom
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15
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Buzi RS, Smith PB, Kozinetz CA, Wiemann CM. Pregnant Adolescents As Perpetrators and Victims of Intimate Partner Violence. JOURNAL OF INTERPERSONAL VIOLENCE 2020; 35:2492-2510. [PMID: 29294718 DOI: 10.1177/0886260517704228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The role of pregnant adolescents as perpetrators of intimate partner violence (IPV) is not well understood. Socioecological factors associated with IPV (physical assault and injury, and psychological aggression) perpetrated by pregnant adolescents and the association between IPV and attitudes toward the use of physical punishment to discipline children were examined among 246 pregnant adolescents. Pregnant adolescents were more likely to report perpetrating both physical assault (24%) and psychological aggression (52.7%) than being the recipient (12.2% and 38.6%, respectively) and having been physically injured (7%) than inflicting injury (4.1%). Risk factors for perpetrating physical assault included prior assault by partner, being African American, exposure to community violence, being in trouble with the police, and multiple lifetime drug use. IPV perpetrators had more favorable attitudes toward the use of physical punishment. Interventions should address IPV and parenting attitudes in young couples to maximize the health and safety of both mother and unborn child.
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Affiliation(s)
- Ruth S Buzi
- Baylor College of Medicine, Houston, TX, USA
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16
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Zheng B, Zhu X, Hu Z, Zhou W, Yu Y, Yin S, Xu H. The prevalence of domestic violence and its association with family factors: a cross-sectional study among pregnant women in urban communities of Hengyang City, China. BMC Public Health 2020; 20:620. [PMID: 32370810 PMCID: PMC7201570 DOI: 10.1186/s12889-020-08683-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 04/08/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND With the increased vulnerability during pregnancy, domestic violence (DV) is a serious threat to the physical and mental health of pregnant women, making it a significant issue in public health initiatives. In China, family is of great significance to pregnant women, but few scholars have focused specifically on the relationship between the family factors of pregnant women and DV. This study aimed to explore the prevalence and association between family factors and DV among women in late pregnancy, to provide evidence for the prevention of domestic violence during pregnancy. METHODS A cross-sectional survey was conducted from July-October, 2019 among pregnant women in urban communities of Hengyang City, Hunan Province, China. A total of 813 participants were included by a multi-staged cluster random sampling method. DV was assessed by the Abuse Assessment Screen Questionnaire (AAS). A multivariate binary logistic regression model was used to evaluate the relationship between family factors and DV. RESULTS Ultimately, 127 (15.62%) participants were identified as victims of DV. After adjustment, the potential risk factors of DV were tensions between their mother-in-law and other family members (OR: 2.85; 95% CI: 1.29 to 6.30 and OR: 3.30; 95% CI: 1.57 to 6.93), medium household debt (OR: 2.17; 95% CI: 1.18 to 4.00), middle and low family APGARI (OR: 2.01; 95% CI: 1.30 to 3.13 and OR: 4.01; 95% CI: 2.09 to 7.69). CONCLUSIONS In summary, women in late pregnancy were at higher risk of DV in the family with tensions, medium household debt and family dysfunction, which may help medical personnel intervene in cases of domestic violence against pregnant women in a reasonable and timely manner.
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Affiliation(s)
- Baohua Zheng
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Xidi Zhu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Zhao Hu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Wensu Zhou
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Yunhan Yu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Shilin Yin
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Huilan Xu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China.
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17
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Bellizzi S, Nivoli A, Salaris P, Ronzoni AR, Pichierri G, Palestra F, Wazwaz O, Luque-Fernandez MA. Sexual violence and eclampsia: analysis of data from Demographic and Health Surveys from seven low- and middle-income countries. J Glob Health 2019; 9:020434. [PMID: 31777658 PMCID: PMC6858987 DOI: 10.7189/jogh.09.020434] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Background Scientific literature has provided clear evidence of the profound impact of sexual violence on women’s health, such as somatic disorders and mental adverse outcomes. However, consequences related to obstetric complications are not yet completely clarified. This study aimed to assess the association of lifetime exposure to intimate partner sexual violence with eclampsia. Methods We considered all the seven Demographic and Health Surveys (DHS) that included data on sexual violence and on signs and symptoms suggestive of eclampsia for women of reproductive age (15-49 years). We computed unadjusted and adjusted odds ratios (OR) to evaluate the risk of suggestive eclampsia by ever subjected to sexual violence. A sensitivity analysis was conducted restricting the study population to women who had their last live birth over the 12 months before the interview. Results Self-reported experience of sexual violence ranged from 3.7% in Mali to 9.2% in India while prevalence of women reporting signs and symptoms compatible with eclampsia ranged from 14.3% in Afghanistan to 0.7% in the Philippines. Reported sexual violence was associated with a 2-fold increased odd of signs and symptoms suggestive of eclampsia in the pooled analysis. The sensitivity analysis confirmed the strength of the association between sexual violence and eclampsia in Afghanistan and in India. Conclusions Women and girls in low-and-middle-income countries are at high risk of sexual violence, which may represent a risk factor for hypertensive obstetric complication. Accurate counseling by health care providers during antenatal care consultations may represent an important opportunity to prevent adverse outcomes during pregnancy.
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Affiliation(s)
- Saverio Bellizzi
- Partnership for Maternal, Newborn & Child Health, Geneva, Switzerland
| | - Alessandra Nivoli
- Department of Neuroscience, Institute of Psychiatry, University of Sassari, Sassari, Italy
| | - Paola Salaris
- Department of Endocrinology, Mater Olbia Hospital, Olbia, Italy
| | | | - Giuseppe Pichierri
- Kingston Hospital NHS Foundation Trust, Galsworthy Road, Kingston upon Thames, UK
| | | | - Ola Wazwaz
- Partnership for Maternal, Newborn & Child Health, Geneva, Switzerland
| | - Miguel Angel Luque-Fernandez
- Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.,Biomedical Research Institute of Granada, Non-Communicable and Cancer Epidemiology Group (ibs.Granada), Andalusian School of Public Health, Granada, University of Granada, Spain
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18
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Bauleni EM, Hooker L, Vally HP, Taft A. Intimate-partner violence and reproductive decision-making by women attending Victorian Maternal- and Child-Health services: a cross-sectional study. Aust J Prim Health 2019; 24:422-427. [PMID: 30107139 DOI: 10.1071/py17183] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 04/23/2018] [Indexed: 11/23/2022]
Abstract
The reproductive years are a critical period where women experience greater risk of intimate-partner violence (IPV). Most studies investigating the association between IPV and reproductive health have been completed in low- and middle-income countries. This study aimed to examine the relationship between IPV and women's reproductive decision-making in Victoria, Australia. We analysed secondary data from a cluster-randomised trial of IPV screening that surveyed new mothers attending Maternal- and Child-Health centres in Melbourne. Survey measures included the experience of partner abuse in the past 12 months using the Composite Abuse Scale and four reproductive decision-making indicators. Results showed that IPV affects reproductive decision-making among postpartum women. Women who reported abuse were less likely to plan for a baby (adjusted Odds Ratio 0.48, 95% CI: 0.31-0.75) than were non-abused women, significantly more likely to have partners make decisions for them about contraception (Risk ratio (RR) 4.09, 95% CI: 1.31-12.75), and whether and when to have a baby (RR 12.35, 95% CI: 4.46-34.16), than they were to make decisions jointly. Pregnant and postpartum women need to be screened for partner violence that compromises women's decision-making power regarding their reproductive rights.
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Affiliation(s)
- Esther M Bauleni
- School of Psychology and Public Health, La Trobe University, Kingsbury Drive, Bundoora , Vic. 3086, Australia
| | - Leesa Hooker
- Department of Rural Nursing and Midwifery, La Trobe Rural Health School, PO Box 199, Bendigo, Vic. 3552, Australia
| | - Hassan P Vally
- School of Psychology and Public Health, La Trobe University, Kingsbury Drive, Bundoora , Vic. 3086, Australia
| | - Angela Taft
- Judith Lumley Centre (for mother, infant and family health research), School of Nursing and Midwifery, La Trobe University, Kingsbury Drive, Bundoora, Vic. 3086, Australia
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19
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Cohodes EM, Gee DG, Lieberman AF. Associations between prenatal substance exposure, prenatal violence victimization, unintended pregnancy, and trauma exposure in childhood in a clinical setting. Infant Ment Health J 2019; 40:786-798. [DOI: 10.1002/imhj.21815] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | | | - Alicia F. Lieberman
- Child Trauma Research ProgramDepartment of PsychiatryUniversity of California San Francisco California
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20
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Arstein-Kerslake A. Gendered denials: Vulnerability created by barriers to legal capacity for women and disabled women. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2019; 66:101501. [PMID: 31706406 DOI: 10.1016/j.ijlp.2019.101501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 09/03/2019] [Accepted: 09/03/2019] [Indexed: 06/10/2023]
Abstract
This article explores the vulnerability that is created when legal capacity is denied to women and disabled women. It argues that vulnerability is largely contingent on social constructs - as opposed to being an inherent quality of disability or gender. It discusses barriers to the exercise of legal capacity that women and disabled women experience - such as limitations on reproductive choice, higher rates of substituted decision-making, and unique experiences with forced mental health treatment. It then explores evidence that such barriers are disempowering and can leave women and disabled women vulnerable to abuse and marginalisation. It explores financial, physical and sexual abuse that can occur as a result of this vulnerability. Finally, it concludes that autonomy and power are inextricably linked and can be essential for minimising vulnerability.
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Affiliation(s)
- Anna Arstein-Kerslake
- Melbourne Law School, University of Melbourne, 185 Pelham Street, Carlton, VIC 3053, Australia.
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21
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Showalter K, Mengo C, Choi MS. Intimate Partner Violence in India: Abuse in India's Empowered Action Group States. Violence Against Women 2019; 26:972-986. [PMID: 31179897 DOI: 10.1177/1077801219848500] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Married women in India experience intimate partner violence (IPV) at alarming rates. This study explores regional differences in Indian women's physical IPV experiences by looking at the effect of living in eight Empowered Action Group (EAG) states. It is hypothesized that women in EAG states will be more likely to have experienced physical IPV than women living outside EAG states. A sample of 65,587 women was selected from the 2005-2006 India National Family Health Survey (NFHS-3). Counter to our hypothesis, logistic regression results show that living in an EAG state decreases likelihood of physical IPV in the past 12 months.
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Narayan AJ, Hagan MJ, Cohodes E, Rivera LM, Lieberman AF. Early Childhood Victimization and Physical Intimate Partner Violence During Pregnancy: A Developmental and Person-Oriented Approach. JOURNAL OF INTERPERSONAL VIOLENCE 2019; 34:3-26. [PMID: 27044489 DOI: 10.1177/0886260516639261] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Intimate partner violence (IPV) victimization during pregnancy is a major public health concern, yet little is known about how risk factors for IPV during pregnancy may depend on whether women have histories of victimization dating back to early childhood (ages 0-5 years). This study examined whether risk factors for physical IPV victimization during pregnancy (a pregnancy that was not planned and prenatal substance use) differed for women with versus without early childhood victimization. Participants were 236 ethnically diverse, low-income biological mothers ( M = 30.94 years; 50.0% Latina, 16.9% Caucasian, 13.1% African American, and 16.9% multiracial) of children aged 0 to 6 years. Mothers were classified into four groups based on whether they had experienced early childhood victimization and physical IPV victimization during pregnancy with the target child. Multinomial logistic regressions, controlling for demographic characteristics, examined whether a pregnancy not planned and prenatal substance use predicted group membership. Compared to mothers with early victimization only, mothers with both early childhood victimization and physical IPV during pregnancy were more than 3 times as likely to report that their pregnancy with the target child was not planned. In follow-up analyses, mothers with early victimization and physical IPV during pregnancy also reported higher lifetime parity than mothers with physical IPV during pregnancy but no early victimization. Early childhood victimization may place women on a risk pathway to physical IPV during pregnancy, particularly if the pregnancy is not planned. Prevention and policy efforts should screen women for early childhood victimization to understand risks for physical IPV during pregnancy.
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Masho SW, Rozario S, Walker D, Cha S. Racial Differences and the Role of Marital Status in the Association Between Intimate Partner Violence and Unintended Pregnancy. JOURNAL OF INTERPERSONAL VIOLENCE 2018; 33:3162-3185. [PMID: 26940349 DOI: 10.1177/0886260516635317] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
More than half of all pregnancies in the U.S. are unintended which may lead to poor health outcomes. Racial and ethnic differences underlying the association between IPV and unintended pregnancy are inconsistent. This study examines the association between IPV and unintended pregnancy across racial/ethnic and marital strata among U.S. women. Data from the national 2009/11 Pregnancy Risk Assessment Monitoring System consisting of women who recently delivered a live birth baby were analyzed (n=108,220). A dichotomous variable was created to indicate whether women experienced IPV in the 12 months leading to their most recent pregnancy (yes; no). The outcome, pregnancy intention, was dichotomized as intended or unintended. Subpopulation analysis was conducted stratified by race/ethnicity and marital status. Adjusted odds ratios and 95% confidence intervals were generated using multiple logistic regression models. The odds of unintended pregnancy were increased for married non-Hispanic White women who reported IPV compared to their non-abused counterparts even after controlling for sociodemographic factors, health care access, and reproductive history. Among unmarried non-Hispanic other women, abused women were significantly less likely to report unintended pregnancy than the non-abused. No significant differences were observed for Hispanic or non-Hispanic Black women. There are significant racial and ethnic differences in the association between IPV and unintended pregnancy. Additionally, the association differed by marital status. Public health professionals and health care providers should be aware of these differences.
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Affiliation(s)
- Saba W Masho
- 1 Virginia Commonwealth University, Richmond, USA
| | | | - D'Won Walker
- 1 Virginia Commonwealth University, Richmond, USA
| | - Susan Cha
- 1 Virginia Commonwealth University, Richmond, USA
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Chaquisse E, Fraga S, Meireles P, Macassa G, Soares J, Mbofana F, Barros H. Sexual and physical intimate partner violence among women using antenatal care in Nampula, Mozambique. J Public Health Afr 2018; 9:744. [PMID: 30079164 PMCID: PMC6057723 DOI: 10.4081/jphia.2018.744] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 08/17/2017] [Indexed: 11/23/2022] Open
Abstract
The aim was to estimate the prevalence of sexual and physical intimate partner violence (IPV) and its associated factors, in a sample of pregnant women using antenatal care (ANC) in Nampula province - Mozambique. This cross-sectional study was carried out in six health units in Nampula, from February 2013 to January 2014. Overall, 869 participants answered the Conflict Tactics Scale 2. The lifetime and past year prevalence of sexual abuse was 49% and 46%, and of physical abuse was 46% and 44%, respectively. Lifetime and past year sexual abuse was significantly associated with living as a couple, alcohol drinking and having a past diagnosis of gonorrhea. Lifetime and past year physical abuse increased significantly with age and was associated with living as a couple, alcohol drinking and history with syphilis. The prevalence of lifetime and previous year violence among women using ANC was high and similar showing that most women were constantly exposed to IPV. ANC provides a window of opportunity for identifying and acting on violence against women.
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Affiliation(s)
- Eusébio Chaquisse
- EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Portugal.,Faculdade de Ciências de Saúde, University of Lúrio, Nampula, Moçambique.,National Health Institute, Maputo, Mozambique
| | - Sílvia Fraga
- EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Portugal.,Faculdade de Medicina, Universidade do Porto, Portugal
| | - Paula Meireles
- EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Portugal
| | - Glória Macassa
- EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Portugal.,Department of Occupational and Public Health Sciences, University of Gävle, Gävle, Sweden
| | - Joaquim Soares
- EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Portugal.,Department of Health Sciences, Section of Public Health Sciences, Mid Sweden University, Sundsvall, Sweden
| | | | - Henrique Barros
- EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Portugal.,Faculdade de Medicina, Universidade do Porto, Portugal
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Yee LM, Crisham Janik M, Dorman RM, Chong PS, Garcia PM, Miller ES. Relationship between intimate partner violence and antiretroviral adherence and viral suppression in pregnancy. SEXUAL & REPRODUCTIVE HEALTHCARE 2018; 17:7-11. [PMID: 30193723 DOI: 10.1016/j.srhc.2018.05.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 04/20/2018] [Accepted: 05/02/2018] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To determine whether intimate partner violence (IPV) during pregnancy is associated with increased risk of clinical factors that influence maternal to child transmission (MTCT) of HIV. STUDY DESIGN Retrospective cohort study of pregnant women living with HIV (WLHIV) who received prenatal care in a multidisciplinary perinatal HIV clinic (2007-2014). All women were assessed for IPV status during pregnancy by a social worker and/or health psychologist. Records were abstracted for obstetric information and factors associated with MTCT of HIV, including antenatal visit attendance, adherence to antiretroviral regimen, time until viral suppression after initiation of antiretroviral medications, HIV RNA at 36 weeks and at delivery, and preterm birth. Women who reported IPV were compared to those who did not using bivariable and multivariable logistic and linear regression analyses. RESULTS Of 215 women receiving care during the study period, 91.6% (N = 197) had documentation of IPV history. Of these women, 13.7% (N = 27) reported experiencing IPV during pregnancy. Women who reported IPV were less likely to be completely adherent to antiretroviral doses (38.5% vs. 62.0%, p = 0.039) and required significantly more time to achieve stable virologic suppression (16.0 vs. 8.5 weeks, p = 0.010). Time to achieve suppression remained significant in multivariable models (β 4.68, 95% CI 0.03-9.32). CONCLUSION IPV during a pregnancy complicated by HIV appears to be associated with decreased antiretroviral adherence. Pregnant WLHIV who reported IPV exhibited delays in achieving virologic suppression. These women represent a vulnerable population who may require additional support and interventions to reduce the risk of MTCT of HIV.
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Affiliation(s)
- Lynn M Yee
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
| | - Mary Crisham Janik
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Robin M Dorman
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Phyllis S Chong
- Department of Social Work, Northwestern Memorial Hospital, Chicago, IL, USA
| | - Patricia M Garcia
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Emily S Miller
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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TePoel MRW, Saftlas AF, Wallis AB, Harland K, Peek-Asa C. Help-Seeking Behaviors of Abused Women in an Abortion Clinic Population. JOURNAL OF INTERPERSONAL VIOLENCE 2018; 33:1604-1628. [PMID: 26729745 DOI: 10.1177/0886260515619168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Women who seek induced abortion procedures experience high rates of intimate partner violence, yet little is known about their help-seeking behaviors. Using data collected from patients attending a large Midwestern clinic who screened positive for intimate partner violence, we analyzed how help-seeking women differed from women not seeking help and those not disclosing their help-seeking behavior. We measured current and planned resource use and evaluated self-perceived helpfulness of resources. Severe battering, physical and/or sexual abuse, frequent sexual abuse, increased relationship length, and employment were positively associated with help-seeking. Nearly half of women who screened positive for abuse in the past year had already sought or planned to seek help, indicating this population is receptive to intervention.
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Grilo SA, Catallozzi M, Heck CJ, Mathur S, Nakyanjo N, Santelli JS. Couple perspectives on unintended pregnancy in an area with high HIV prevalence: A qualitative analysis in Rakai, Uganda. Glob Public Health 2018. [PMID: 29536817 DOI: 10.1080/17441692.2018.1449233] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Understanding how couples perceive a recent unintended pregnancy in the context of HIV infection and high levels of gender inequality may provide insights for prevention of undesired pregnancy. We used data from 24 in-depth interviews with 8 HIV-serodiscordant and 4 seroconcordant couples living in rural Uganda and interviewed separately; between 15 and 49 years and one or both identified the pregnancy as unintended. A dyadic analysis was performed to understand each partner's perspectives on experiences of a specific pregnancy. We used the social-ecological model to guide the analysis. Issues of agency were commonly invoked in describing pregnancy. Women often cited factors that demonstrated a lack of control when making decisions about continuing the pregnancy. Men often expressed a lack of agency or control over preventing their female partner from becoming pregnant. There was much disagreement between partners about intentions regarding the specific pregnancy. Likewise, lack of communication about child spacing and pregnancy intentions was common among couples. HIV serostatus played a role in some discussions of pregnancy intention among serodiscordant couples. This qualitative analysis supports prior quantitative research on the complexity of pregnancy intentions. A lack of agency at the individual level was compounded by a lack of communication between partners.
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Affiliation(s)
- Stephanie A Grilo
- a Sociomedical Sciences , Columbia University Mailman School of Public Health , New York , NY , USA
| | - Marina Catallozzi
- b Heilbrunn Department of Population and Family Health , Columbia University Mailman School of Public Health , New York , NY , USA.,c Department of Pediatrics, Columbia University Medical Center , New York , NY , USA.,d Morgan Stanley Children's Hospital, New York-Presbyterian Hospital , New York , NY , USA
| | - Craig J Heck
- b Heilbrunn Department of Population and Family Health , Columbia University Mailman School of Public Health , New York , NY , USA
| | | | | | - John S Santelli
- b Heilbrunn Department of Population and Family Health , Columbia University Mailman School of Public Health , New York , NY , USA
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Wang T, Liu Y, Li Z, Liu K, Xu Y, Shi W, Chen L. Prevalence of intimate partner violence (IPV) during pregnancy in China: A systematic review and meta-analysis. PLoS One 2017; 12:e0175108. [PMID: 28968397 PMCID: PMC5624577 DOI: 10.1371/journal.pone.0175108] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Accepted: 03/18/2017] [Indexed: 11/19/2022] Open
Abstract
Background Intimate partner violence (IPV) is the most common form of violence against women worldwide. IPV during pregnancy is an important risk factor for adverse health outcomes for women and their offspring. However, the prevalence of IPV during pregnancy is not well understood in China. The objective of this study was to estimate the pooled prevalence of IPV during pregnancy in China using a systematic review and meta-analysis. Methods Systematic literature searches were conducted in PubMed, Web of Science, CNKI, Wanfang, Weipu and CBM databases to identify relevant articles published from the inception of each database to January 31, 2016 that reported data on the prevalence of IPV during pregnancy in China. The Risk of Bias Tool for prevalence studies was used to assess the risk of bias in individual studies. Owing to significant between-study heterogeneity, a random-effects model was used to calculate the pooled prevalence and corresponding 95% confidence interval, and then univariate meta-regression analyses were performed to investigate the sources of heterogeneity. Subgroup analysis was conducted to explore the risk factors associated with IPV during pregnancy. Results Thirteen studies with a total of 30,665 individuals were included in this study. The overall pooled prevalence of IPV during pregnancy was 7.7% (95% CI: 5.6–10.1%) with significant heterogeneity (I2 = 97.8%, p < 0.001). The results of the univariate meta-regression analyses showed that only the variable “sample source” explained part of the heterogeneity in this study (p < 0.05). The characteristics “number of children” and “unplanned pregnancy” were determined as risk factors for experiencing violence during pregnancy. Conclusions The prevalence of IPV during pregnancy in China is considerable and one of the highest reported in Asia, which suggests that issues of violence against women during pregnancy should be included in efforts to improve the health of pregnant women and their offspring. In addition, a nationwide epidemiological study is needed to confirm the prevalence estimates and identify more risk factors for IPV during pregnancy.
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Affiliation(s)
- Tingting Wang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, China
| | - Yuan Liu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, China
| | - Zhanzhan Li
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Kaihua Liu
- Department of Toxicology, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, China
| | - Yang Xu
- Deyang Center for Disease Control and Prevention, Deyang, Sichuan Province, China
| | - Wenpei Shi
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, China
| | - Lizhang Chen
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, China
- * E-mail:
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Alhusen JL, Geller R, Dreisbach C, Constantoulakis L, Siega-Riz AM. Intimate Partner Violence and Gestational Weight Gain in a Population-Based Sample of Perinatal Women. J Obstet Gynecol Neonatal Nurs 2017; 46:390-402. [PMID: 28294945 PMCID: PMC5423819 DOI: 10.1016/j.jogn.2016.12.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2016] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To examine the effects of intimate partner violence (IPV) at varied time points in the perinatal period on inadequate and excessive gestational weight gain. DESIGN Retrospective cohort using population-based secondary data. SETTING Pregnancy Risk Assessment Monitoring System and birth certificate data from New York City and 35 states. PARTICIPANTS Data were obtained for 251,342 U.S. mothers who gave birth from 2004 through 2011 and completed the Pregnancy Risk Assessment Monitoring System survey 2 to 9 months after birth. METHODS The exposure was perinatal IPV, defined as experiencing physical abuse by a current or ex-partner in the year before or during pregnancy. Adequacy of gestational weight gain (GWG) was categorized using 2009 Institute of Medicine guidelines. Weighted descriptive statistics and multivariate logistic regression models were used. RESULTS Approximately 6% of participants reported perinatal IPV, 2.7% reported IPV in the year before pregnancy, 1.1% reported IPV during pregnancy only, and the remaining 2.5% reported IPV before and during pregnancy. Inadequate GWG was more prevalent among participants who experienced IPV during pregnancy and those who experienced IPV before and during pregnancy (23.3% and 23.5%, respectively) than in participants who reported no IPV (20.2%; p < .001). Participants who experienced IPV before pregnancy only were significantly more likely to have excessive GWG (p < .001). Results were attenuated in the multivariate modeling; only participants who experienced IPV before pregnancy had weakly significant odds of excessive GWG (adjusted odds ratio = 1.14, 95% CI [1.02, 1.26]). CONCLUSION The association between perinatal IPV and inadequate GWG was explained by confounding variables; however, women who reported perinatal IPV had greater rates of GWG outside the optimal range. Future studies are needed to determine how relevant confounding variables may affect a woman's GWG.
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Baird K, Creedy D, Mitchell T. Intimate partner violence and pregnancy intentions: a qualitative study. J Clin Nurs 2017; 26:2399-2408. [DOI: 10.1111/jocn.13394] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2016] [Indexed: 11/26/2022]
Affiliation(s)
- Kathleen Baird
- School of Nursing and Midwifery; Menzies Health Institute Queensland; Griffith University; University Drive; Meadowbrook Qld Australia
- Women’s & Newborn Services; Gold Coast University Hospital; Qld Australia
| | - Debra Creedy
- School of Nursing and Midwifery; Menzies Health Institute Queensland; Griffith University; University Drive; Meadowbrook Qld Australia
| | - Theresa Mitchell
- Institute of Health & Society; University of Worcester; Worcester UK
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Exploring the associations between intimate partner violence victimization during pregnancy and delayed entry into prenatal care: Evidence from a population-based study in Bangladesh. Midwifery 2017; 47:43-52. [PMID: 28237897 DOI: 10.1016/j.midw.2017.02.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 12/14/2016] [Accepted: 02/05/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Intimate partner violence (IPV) during pregnancy can have serious health consequences for mothers and newborns. The aim of the study is to explore: 1) the influence of experiencing IPV during pregnancy on delayed entry into prenatal care; and 2) whether women's decision-making autonomy and the support for traditional gender roles act to mediate or moderate the relationship between IPV and delayed entry into prenatal care. DESIGN cross-sectional survey. Multivariate logistic regression models were estimated that control for various socio-demographic and pregnancy related factors to assess whether women who experienced IPV during pregnancy were more likely to delay entry into prenatal care compared with women who had not experienced IPV. The influence of traditional gender roles acceptance and decision-making autonomy were examined both as independent variables and in interaction with IPV, to assess their role as potential mediators or moderators. SETTING Chandpur district, Bangladesh. PARTICIPANTS the sample comprised of 426 Bangladeshi women, aged 15-49 years. Postpartum mothers who visited vaccinations centres to receive their children's vaccinations constitute the sampling frame. RESULTS almost 70% of the women surveyed reported patterns consistent with delayed entry into prenatal care. Accounting for the influence of other covariates, women who experienced physical IPV during pregnancy were 2.61 times more likely (95% CI [1.33, 5.09]) to have delayed entry into prenatal care than their counterparts who did not report physical IPV. Neither sexual nor psychological IPV victimization during pregnancy was linked with late entry into prenatal care. Both gender role attitudes and levels of autonomy mediate the effect of IPV on prenatal care. KEY CONCLUSIONS the results suggest that the high rates of IPV in Bangladesh have effects that can compromise women's health seeking behaviour during pregnancy, putting them and their developing fetus at risk. Specifically, Bangladeshi women who experience physical IPV during pregnancy are more likely to delay or forgo prenatal care, an effect that is further magnified by cultural ideals that emphasize women's traditional roles and limit their autonomy. IMPLICATIONS FOR PRACTICE this study reinforces the need to detect and assist women suffering IPV, not only to offer them help and support but also to increase entry into prenatal care. Healthcare professionals involved in obstetrics and midwifery need to be aware of the risk factors of IPV during pregnancy and be able to identify women who are at risk for delayed entry into prenatal care.
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Martin CR, Hollins Martin CJ, Burduli E, Barbosa-Leiker C, Donovan-Batson C, Fleming SE. Measurement and structural invariance of the US version of the Birth Satisfaction Scale-Revised (BSS-R) in a large sample. Women Birth 2016; 30:e172-e178. [PMID: 27965174 DOI: 10.1016/j.wombi.2016.11.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 11/08/2016] [Accepted: 11/10/2016] [Indexed: 01/23/2023]
Abstract
BACKGROUND The 10-item Birth Satisfaction Scale-Revised (BSS-R) is being increasingly used internationally. The use of the measure and the concept has gathered traction in the United States following the development of a US version of the tool. A limitation of previous studies of the measurement characteristics of the BSS-R is modest sample size. Unplanned pregnancy is recognised as being associated with a range of negative birth outcomes, but the relationship to birth satisfaction has received little attention, despite the importance of birth satisfaction to a range of postnatal outcomes. AIM The current investigation sought to evaluate the measurement characteristics of the BSS-R in a large postpartum sample. METHODS Multiple Groups Confirmatory Factor Analysis (MGCFA) was used to evaluate a series of measurement and structural models of the BSS-R to evaluate fundamental invariance characteristics using planned/unplanned pregnancy status to differentiate groups. FINDINGS Complete data from N=2116 women revealed that the US version of the BSS-R offers an excellent fit to data and demonstrates full measurement and structural invariance. Little difference was observed between women on the basis of planned/unplanned pregnancy stratification on measures of birth satisfaction. DISCUSSION The established relationship between unplanned pregnancy and negative perinatal outcomes was not found to extend to birth satisfaction in the current study. The BSS-R demonstrated exemplary measurement and structural invariance characteristics. CONCLUSION The current study strongly supports the use of the US version of the BSS-R to compare birth satisfaction across different groups of women with theoretical and measurement confidence.
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Affiliation(s)
- Colin R Martin
- Faculty of Society and Health, Buckinghamshire New University, Uxbridge, UB8 1NA, UK.
| | | | - Ekaterina Burduli
- Sleep and Performance Research Center, Elson S. Floyd College of Medicine, Washington State University, Spokane, Washington State, USA.
| | | | | | - Susan E Fleming
- Seattle University College of Nursing, Seattle, Washington State, USA.
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Mohammad-Alizadeh-Charandabi S, Bahrami-Vazir E, Kamalifard M, Mirghafourvand M. Intimate partner violence during the first pregnancy: A comparison between adolescents and adults in an urban area of Iran. J Forensic Leg Med 2016; 43:53-60. [PMID: 27450537 DOI: 10.1016/j.jflm.2016.07.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 05/21/2016] [Accepted: 07/03/2016] [Indexed: 11/16/2022]
Abstract
There is uncertain evidence that intimate partner violence (IPV) during pregnancy is more common among adolescents. We aimed to compare prevalence and chronicity of IPV during the first pregnancy between adolescents and adults. 136 women aged 15 to 19 and 272 women aged 20-29 years between 24 and 30 weeks gestation (stratified by center) were examined at all 80 public health centers/posts in Tabriz-Iran. IPV was assessed using the revised conflict tactics scales. The adolescents and adults reported roughly the same rate of overall IPV perpetration (72% vs. 71%, p = 0.816). Rate of victimization was slightly higher among the adolescents (69% vs. 62%) but the difference was not statistically significant (p = 0.144). The most common types of IPV perpetration and victimization in the both groups were psychological aggression, followed by physical assault and sexual coercion. Using only two physical assault and sexual coercion subscales, rate of IPV perpetration fell to 40% vs. 28%, p = 0.016 and victimization fell to 46% vs. 38%, p = 0.227. There were no statistically significant differences between the groups in terms of prevalence and chronicity of various types of IPV, except sexual coercion victimization which was more prevalent among the adolescents (31% vs. 21%, p = 0.034). The high rates of IPV perpetration and victimization during pregnancy among both adolescents and adults in the study area with significant higher risk of sexual coercion victimization among adolescents require health policy makers and care providers to have serious efforts for its reduction.
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Affiliation(s)
- Sakineh Mohammad-Alizadeh-Charandabi
- Social Determinants of Health Research Centre, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Islamic Republic of Iran.
| | - Ellahe Bahrami-Vazir
- Students' Research Committee, Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Islamic Republic of Iran.
| | - Mahin Kamalifard
- Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Islamic Republic of Iran.
| | - Mojgan Mirghafourvand
- Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Islamic Republic of Iran.
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Campbell J, García-Moreno C, Sharps P. Abuse During Pregnancy in Industrialized and Developing Countries. Violence Against Women 2016. [DOI: 10.1177/1077801204265551] [Citation(s) in RCA: 150] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Abuse during pregnancy has increasingly been identified as an important problem with significant consequences for maternal and infant health, particularly in North America. The authors review available evidence of the prevalence and consequences of abuse during pregnancy, including maternal mortality, outside of North America. The range of prevalence found in developing countries is much wider (3.8% to 31.7%) than that of industrialized countries (3.4% to 11%), which is much closer to findings from North America. There is a need for more studies using consistent definitions and methodologies to examine the patterns and forms of abuse related to pregnancy worldwide.
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Donovan BM, Spracklen CN, Schweizer ML, Ryckman KK, Saftlas AF. Intimate partner violence during pregnancy and the risk for adverse infant outcomes: a systematic review and meta-analysis. BJOG 2016; 123:1289-99. [DOI: 10.1111/1471-0528.13928] [Citation(s) in RCA: 131] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2016] [Indexed: 11/28/2022]
Affiliation(s)
- BM Donovan
- Department of Epidemiology; College of Public Health; University of Iowa; Iowa City IA USA
| | - CN Spracklen
- Department of Genetics; University of North Carolina; Chapel Hill NC USA
| | - ML Schweizer
- Department of Internal Medicine; Carver College of Medicine; University of Iowa; Iowa City IA USA
- Iowa City VA Health Care System; Iowa City IA USA
| | - KK Ryckman
- Department of Epidemiology; College of Public Health; University of Iowa; Iowa City IA USA
- Department of Pediatrics; Carver College of Medicine; University of Iowa; Iowa City IA USA
| | - AF Saftlas
- Department of Epidemiology; College of Public Health; University of Iowa; Iowa City IA USA
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Stephenson R, Jadhav A, Winter A, Hindin M. Domestic Violence and Abortion Among Rural Women in Four Indian States. Violence Against Women 2016; 22:1642-1658. [PMID: 26902676 DOI: 10.1177/1077801216630148] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The prevalence of domestic violence and abortion in India is high, yet little is known about the relationship between these experiences. Data from two linked data sets, India's 1998-1999 National Family Health Survey (NFHS-2) and a follow-up survey in 2002-2003, were analyzed. The analysis examines how the experience of physical violence affects the subsequent uptake of abortion, and how the experience of abortion affects subsequent experience of physical, sexual, and verbal violence. Women who experienced physical violence have significantly higher odds of reporting a subsequent induced abortion, whereas women who had an induced abortion have significantly higher odds of reporting subsequent sexual and verbal violence. There was no significant relationship between domestic violence and spontaneous abortion.
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Affiliation(s)
| | | | | | - Michelle Hindin
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Kingston D, Heaman M, Urquia M, O’Campo P, Janssen P, Thiessen K, Smylie J. Correlates of Abuse Around the Time of Pregnancy: Results from a National Survey of Canadian Women. Matern Child Health J 2015; 20:778-89. [DOI: 10.1007/s10995-015-1908-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Waters SF, Hagan MJ, Rivera L, Lieberman AF. Improvements in the Child-Rearing Attitudes of Latina Mothers Exposed to Interpersonal Trauma Predict Greater Maternal Sensitivity Toward Their 6-Month-Old Infants. J Trauma Stress 2015; 28:426-33. [PMID: 26418308 DOI: 10.1002/jts.22043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The current study investigated maternal sensitivity in a treatment-seeking sample of predominately Latina, low-income pregnant women with histories of interpersonal trauma exposure. Pregnant women (N = 52; M = 27.08 years, SD = 5.66) who enrolled in a study of a perinatal adaptation of child-parent psychotherapy reported on their posttraumatic stress symptoms and child-rearing attitudes at baseline and again at 6-months postpartum. Maternal sensitivity was measured via observational coding of a free-play episode at 6-months postpartum. Two thirds of mothers exhibited healthy levels of maternal sensitivity, M > 4.0 (range = 2.5-7.0). The results of multiple linear regression predicting maternal sensitivity, R(2) = .26, indicated that greater improvements in child-rearing attitudes over the course of treatment predicted higher levels of maternal sensitivity, β = .33, whereas improvements in posttraumatic stress symptoms over the course of treatment did not, β = -.10. Mothers' attitudes regarding parenting during the perinatal period may be a mechanism by which intervention fosters healthy mother-infant relationship dynamics. Thus, parenting attitudes are a worthy target of intervention in vulnerable families.
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Affiliation(s)
- Sara F Waters
- Department of Human Development, Washington State University, Vancouver, Vancouver, Washington, USA.,Department of Psychiatry, Child Trauma Research Program, University of California, San Francisco, San Francisco, California, USA
| | - Melissa J Hagan
- Department of Psychiatry, Child Trauma Research Program, University of California, San Francisco, San Francisco, California, USA.,Department of Psychology, San Francisco State University, San Francisco, California, USA
| | - Luisa Rivera
- Department of Psychiatry, Child Trauma Research Program, University of California, San Francisco, San Francisco, California, USA
| | - Alicia F Lieberman
- Department of Psychiatry, Child Trauma Research Program, University of California, San Francisco, San Francisco, California, USA
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Ramo-Fernández L, Schneider A, Wilker S, Kolassa IT. Epigenetic Alterations Associated with War Trauma and Childhood Maltreatment. BEHAVIORAL SCIENCES & THE LAW 2015; 33:701-721. [PMID: 26358541 DOI: 10.1002/bsl.2200] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Survivors of war trauma or childhood maltreatment are at increased risk for trauma-spectrum disorders such as post-traumatic stress disorder (PTSD). In addition, traumatic stress has been associated with alterations in the neuroendocrine and the immune system, enhancing the risk for physical diseases. Traumatic experiences might even affect psychological as well as biological parameters in the next generation, i.e. traumatic stress might have transgenerational effects. This article outlines how epigenetic processes, which represent a pivotal biological mechanism for dynamic adaptation to environmental challenges, might contribute to the explanation of the long-lasting and transgenerational effects of trauma. In particular, epigenetic alterations in genes regulating the hypothalamus-pituitary-adrenal axis as well as the immune system have been observed in survivors of childhood and adult trauma. These changes could result in enduring alterations of the stress response as well as the physical health risk. Furthermore, the effects of parental trauma could be transmitted to the next generation by parental distress and the pre- and postnatal environment, as well as by epigenetic marks transmitted via the germline. While epigenetic research has a high potential of advancing our understanding of the consequences of trauma, the findings have to be interpreted with caution, as epigenetics only represent one piece of a complex puzzle of interacting biological and environmental factors. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
| | - Anna Schneider
- Clinical and Biological Psychology, Ulm University, Germany
| | - Sarah Wilker
- Clinical and Biological Psychology, Ulm University, Germany
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Martin-de-las-Heras S, Velasco C, Luna JDD, Martin A. Unintended pregnancy and intimate partner violence around pregnancy in a population-based study. Women Birth 2015; 28:101-5. [DOI: 10.1016/j.wombi.2015.01.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Revised: 01/09/2015] [Accepted: 01/10/2015] [Indexed: 11/25/2022]
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Lukasse M, Laanpere M, Karro H, Kristjansdottir H, Schroll AM, Van Parys AS, Wangel AM, Schei B. Pregnancy intendedness and the association with physical, sexual and emotional abuse - a European multi-country cross-sectional study. BMC Pregnancy Childbirth 2015; 15:120. [PMID: 26008119 PMCID: PMC4494794 DOI: 10.1186/s12884-015-0558-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Accepted: 05/15/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Unintended pregnancies are common and when not resulting in a termination of pregnancy may lead to unintended childbirth. Unintended pregnancies are associated with increased health risks, also for women for whom pregnancy continues to childbirth. Our objective was to present the prevalence of unintended pregnancy in six European countries among pregnant women attending routine antenatal care, and to investigate the association with a history of physical, sexual and emotional abuse. METHODS A prospective cross-sectional study, of 7102 pregnant women who filled out a questionnaire during pregnancy as part of a multi-country cohort study (Bidens) with the participating countries: Belgium, Iceland, Denmark, Estonia, Norway and Sweden. A validated instrument, the Norvold Abuse Questionnaire (NorAq) consisting of 10 descriptive questions measured abuse. Pregnancy intendedness was assessed using a single question asking women if this pregnancy was planned. Cross-tabulation, Chi-square tests and binary logistic regression analysis were used. RESULTS Approximately one-fifth (19.2 %) of all women reported their current pregnancy to be unintended. Women with an unintended pregnancy were significantly younger, had less education, suffered economic hardship, had a different ethnic background from the regional majority and more frequently were not living with their partner. The prevalence of an unintended pregnancy among women reporting any lifetime abuse was 24.5 %, and 38.5 % among women reporting recent abuse. Women with a history of any lifetime abuse had significantly higher odds of unintended pregnancy, also after adjusting for confounding factors, AOR for any lifetime abuse 1.41 (95 % CI 1.23-1.60) and for recent abuse AOR 2.03 (95 % CI 1.54-2.68). CONCLUSION Women who have experienced any lifetime abuse are significantly more likely to have an unintended pregnancy. This is particularly true for women reporting recent abuse, suggesting that women living in a violent relationship have less control over their fertility.
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Affiliation(s)
- Mirjam Lukasse
- Institutt for Health, Nutrition and Management, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway.
| | - Made Laanpere
- Department of Obstetrics and Gynaecology,, University of Tartu, Tartu, Estonia. .,Tartu University Hospital Women's Clinic, Tartu, Estonia.
| | - Helle Karro
- Department of Obstetrics and Gynaecology,, University of Tartu, Tartu, Estonia. .,Tartu University Hospital Women's Clinic, Tartu, Estonia.
| | | | | | - An-Sofie Van Parys
- Department of Obstetrics and Gynaecology, Ghent University Hospital, Ghent, Belgium.
| | | | - Berit Schei
- Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway. .,Department of Obstetrics and Gynaecology, St. Olav's University Hospital, Trondheim, Norway.
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Abstract
Intimate partner violence (IPV) can be defined in many ways and encompasses many different types of physical and emotional abuse. IPV affects the health, safety, and quality of life for women, men, and children worldwide, regardless of race, sexual orientation, or socioeconomic status. The health effects include acute trauma; a wide range of physical and mental sequelae; and, for some, death. Because of the serious consequences of IPV, both the Centers for Disease Control and the World Health Organization identify IPV as a significant public health issue.
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Affiliation(s)
- Nancy Sugg
- Department of Medicine, Harborview's Pioneer Square Clinic, University of Washington, 206 3rd Avenue South, Seattle, WA 98104, USA.
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Prenatal screening for intimate partner violence: A qualitative meta-synthesis. Appl Nurs Res 2015; 28:2-9. [DOI: 10.1016/j.apnr.2014.04.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2013] [Revised: 04/18/2014] [Accepted: 04/20/2014] [Indexed: 11/18/2022]
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Kiykac Altinbas S, Bayoglu Tekin Y, Dilbaz B, Kilic S, Khalil SS, Kandemir O. Impact of having a high-risk pregnancy on future postpartum contraceptive method choice. Women Birth 2014; 27:254-8. [DOI: 10.1016/j.wombi.2014.06.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2013] [Revised: 06/19/2014] [Accepted: 06/20/2014] [Indexed: 10/25/2022]
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Alhusen JL, Ray E, Sharps P, Bullock L. Intimate partner violence during pregnancy: maternal and neonatal outcomes. J Womens Health (Larchmt) 2014; 24:100-6. [PMID: 25265285 DOI: 10.1089/jwh.2014.4872] [Citation(s) in RCA: 201] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The effects of intimate partner violence (IPV) on maternal and neonatal outcomes are multifaceted and largely preventable. During pregnancy, there are many opportunities within the current health care system for screening and early intervention during routine prenatal care or during episodic care in a hospital setting. This article describes the effects of IPV on maternal health (e.g., insufficient or inconsistent prenatal care, poor nutrition, inadequate weight gain, substance use, increased prevalence of depression), as well as adverse neonatal outcomes (e.g., low birth weight [LBW]), preterm birth [PTB], and small for gestational age [SGA]) and maternal and neonatal death. Discussion of the mechanisms of action are explored and include: maternal engagement in health behaviors that are considered "risky," including smoking and alcohol and substance use, and new evidence regarding the alteration of the hypothalamic-pituitary-adrenal axis and resulting changes in hormones that may affect LBW and SGA infants and PTB. Clinical recommendations include a commitment for routine screening of IPV in all pregnant women who present for care using validated screening instruments. In addition, the provision of readily accessible prenatal care and the development of a trusting patient-provider relationship are first steps in addressing the problem of IPV in pregnancy. Early trials of targeted interventions such as a nurse-led home visitation program and the Domestic Violence Enhanced Home Visitation Program show promising results. Brief psychobehavioral interventions are also being explored. The approach of universal screening, patient engagement in prenatal care, and targeted individualized interventions has the ability to reduce the adverse effects of IPV and highlight the importance of this complex social disorder as a top priority in maternal and neonatal health.
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Affiliation(s)
- Jeanne L Alhusen
- 1 Johns Hopkins University , School of Nursing, Baltimore, Maryland
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Lassi ZS, Imam AM, Dean SV, Bhutta ZA. Preconception care: screening and management of chronic disease and promoting psychological health. Reprod Health 2014; 11 Suppl 3:S5. [PMID: 25415675 PMCID: PMC4196564 DOI: 10.1186/1742-4755-11-s3-s5] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION A large proportion of women around the world suffer from chronic diseases including mental health diseases. In the United States alone, over 12% of women of reproductive age suffer from a chronic medical condition, especially diabetes and hypertension. Chronic diseases significantly increase the odds for poor maternal and newborn outcomes in pregnant women. METHODS A systematic review and meta-analysis of the evidence was conducted to ascertain the possible impact of preconception care for preventing and managing chronic diseases and promoting psychological health on maternal, newborn and child health outcomes. A comprehensive strategy was used to search electronic reference libraries, and both observational and clinical controlled trials were included. Cross-referencing and a separate search strategy for each preconception risk and intervention ensured wider study capture. RESULTS Maternal prepregnancy diabetic care is a significant intervention that reduces the occurrence of congenital malformations by 70% (95% Confidence Interval (CI): 59-78%) and perinatal mortality by 69% (95% CI: 47-81%). Furthermore, preconception management of epilepsy and phenylketonuria are essential and can optimize maternal, fetal and neonatal outcomes if given before conception. Ideally changes in antiepileptic drug therapy should be made at least 6 months before planned conception. Interventions specifically targeting women of reproductive age suffering from a psychiatric condition show that group-counseling and interventions leading to empowerment of women have reported non-significant reduction in depression (economic skill building: Mean Difference (MD) -7.53; 95% CI: -17.24, 2.18; counseling: MD-2.92; 95% CI: -13.17, 7.33). CONCLUSION While prevention and management of the chronic diseases like diabetes and hypertension, through counseling, and other dietary and pharmacological intervention, is important, delivering solutions to prevent and respond to women's psychological health problems are urgently needed to combat this leading cause of morbidity.
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Affiliation(s)
- Zohra S Lassi
- Division of Women and Child Health, Aga Khan University Karachi, Pakistan
| | - Ayesha M Imam
- Division of Women and Child Health, Aga Khan University Karachi, Pakistan
| | - Sohni V Dean
- Division of Women and Child Health, Aga Khan University Karachi, Pakistan
| | - Zulfiqar A Bhutta
- Division of Women and Child Health, Aga Khan University Karachi, Pakistan
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Abstract
The notion of preconception care aims to target the existing risks before pregnancy, whereby resources may be used to improve reproductive health and optimize knowledge before conceiving. The preconception period provides an opportunity to intervene earlier to optimize the health of potential mothers (and fathers) and to prevent harmful exposures from affecting the developing fetus. These interventions include birth spacing and preventing teenage pregnancy, promotion of contraceptive use, optimization of weight and micronutrient status, prevention and management of infectious diseases, and screening for and managing chronic conditions. Given existing interventions and the need to organize services to optimize delivery of care in a logical and effective manner, interventions are frequently co-packaged or bundled together. This paper highlights packages of preconception interventions that can be combined and co-delivered to women through various delivery channels and provides a logical framework for development of such packages in varying contexts.
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Affiliation(s)
- Zohra S Lassi
- Division of Women and Child Health, Aga Khan University Karachi, Pakistan
| | - Sohni V Dean
- Division of Women and Child Health, Aga Khan University Karachi, Pakistan
| | - Dania Mallick
- Division of Women and Child Health, Aga Khan University Karachi, Pakistan
| | - Zulfiqar A Bhutta
- Division of Women and Child Health, Aga Khan University Karachi, Pakistan
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Abstract
This article summarizes the literature regarding the epidemiology and prevention of unintended pregnancy in the United States. Because of the Affordable Care Act and its accompanying contraceptive provision, there is a need for more primary care clinicians to provide family planning services. Office-based interventions to incorporate family planning services in primary care are presented, including clinical tools and electronic health record use. Special attention is paid to long-acting reversible contraceptive methods (the subdermal implant and intrauterine devices); these highly effective and safe methods have the greatest potential to decrease the rate of unintended pregnancy, but have been underused.
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Beydoun HA, Beydoun MA. Invited commentary: disclosure of gender-based violence in developing countries. Am J Epidemiol 2014; 179:613-8. [PMID: 24318280 DOI: 10.1093/aje/kwt296] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The evolving concept of gender-based violence (GBV) is a multifaceted issue of public health significance. Until recently, most studies examining GBV have been conducted in North America. In this issue of the Journal, Palermo et al. (Am J Epidemiol. 2014;179(5):602-612) report their secondary analyses involving approximately 300,000 women from 24 developing countries who participated in Demographic and Health Surveys between 2004 and 2011. The focus of their article is on the prevalence and determinants of disclosure of GBV to formal authorities, including health care or legal professionals, police, and nongovernmental organizations. Their results indicate a wide gap between prevalence of GBV (40%) and GBV disclosure (7%), implying an underestimation of GBV that ranges from 11- to 128-fold, depending on the region and type of reporting. The extent of underreporting of GBV also varied according to personal characteristics such as age, marital status and urban or rural residence. GBV has been linked to a myriad of health problems, and it has been shown that health care utilization is considerably higher among women who have experienced GBV. Primary and secondary prevention efforts should continue to target GBV, and creative ways of addressing GBV nondisclosure should take into account regional variations and personal characteristics of affected women.
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Cha S, Masho SW. Intimate partner violence and utilization of prenatal care in the United States. JOURNAL OF INTERPERSONAL VIOLENCE 2014; 29:911-927. [PMID: 24203982 DOI: 10.1177/0886260513505711] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Over 1.5 million women are victims of physical, sexual, and emotional abuse by former or present intimate partners. Intimate partner violence (IPV) around pregnancy can lead to devastating health consequences to mothers and infants. While some research suggests that IPV negatively affects the utilization of health services like prenatal care (PNC), inconsistencies in the assessment of PNC utilization, timing of partner violence, and definitions of IPV yield conflicting results. The objective for the present study is to evaluate whether preconception IPV, prenatal IPV, or IPV in the preconception and/or prenatal period affects PNC utilization. This study analyzed the 2004-2008 national Pregnancy Risk Assessment Monitoring System (PRAMS), which included 202,367 women who delivered a live birth in the United States. IPV victimization was measured using four items that addressed physical abuse by a current or former husband/partner in the 12 months before (preconception) and during (prenatal) pregnancy. Responses were categorized as preconception, prenatal, and preconception and/or prenatal IPV. The outcome was PNC adequacy categorized as inadequate, intermediate, adequate, and adequate plus based on the Adequacy of Prenatal Care Utilization index. Separate logistic regression models provided crude and adjusted odds ratios and 95% confidence intervals (CI). Over 6% of women reported preconception and/or prenatal IPV and 26% had less than adequate PNC. Women who reported abuse before and/or during pregnancy were more likely to have inadequate PNC (odds ratio [OR] = 1.4, 95% CI = [1.3, 1.6]). Similarly, women who experienced preconception or prenatal IPV were 30% more likely to have inadequate PNC (OR = 1.3, 95% CI = [1.2, 1.5]; OR = 1.3, 95% CI = [1.1, 1.7], respectively). Adequate PNC is essential in improving pregnancy outcomes; however, women in abusive relationships may face ongoing challenges and difficulties with obtaining appropriate care. Findings underscore a critical problem and health providers are urged to screen and educate women about IPV during all preconception and prenatal visits.
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Affiliation(s)
- Susan Cha
- Virginia Commonwealth University, VA, Richmond, USA
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