Maternal outcomes associated to psychological and physical intimate partner violence during pregnancy: A cohort study and multivariate analysis
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Martín De Las Heras, Stella; Velasco, Casilda; Luna Del Castillo, Juan De Dios; Saeed Khan, KhalidEditorial
PLOS
Date
2019-06-13Referencia bibliográfica
Martin-de-las-Heras S, Velasco C, Lunadel- Castillo JdD, Khan KS (2019) Maternal outcomes associated to psychological and physical intimate partner violence during pregnancy: A cohort study and multivariate analysis. PLoS ONE 14(6): e0218255
Sponsorship
This work was supported by the Ministry of the Economy and Competitiveness of Spain, National Project I+D+I (FEM2016-79049-R) to SMH.Abstract
Intimate partner violence (IPV) is a public health problem that affects millions of women
worldwide and can occur during both pregnancy and the perinatal period. We aimed to evaluate
if the experience of psychological and physical intimate partner violence (IPV)
adversely affects pregnancy outcomes. We established a cohort of 779 consecutive mothers
receiving antenatal care including ultrasound and giving birth in 15 public hospitals,
drawn using cluster sampling of all obstetric services in Andalusia, Spain (February-June
2010). Trained midwives gathered IPV data using the Index of Spouse Abuse validated in
the Spanish language (score ranges: 0–100, higher scores reflect more severe IPV; cutoffs:
physical IPV = 10, psychological IPV = 25). Socio-demographic data, including lack of
kin support, maternal outcomes, and hospitalization were collected. Multivariate logistic
regression estimated adjusted odds ratios (AOR), with 95% confidence intervals (CI), of the
relationship between psychological and physical IPV and maternal outcomes, controlling for
socio-demographic characteristics. Response rate was 92.2%. Psychological IPV, reported
by 21.0% (n = 151), was associated significantly with urinary tract infection (127 (23%) vs 56
(37%); AOR = 1.9; 95%CI = 1.2–3.0), vaginal infection (30 (5%) vs 20 (13%); AOR = 2.4;
95%CI = 1.2–4.7) and spontaneous preterm labour (32 (6%) vs 19 (13%); AOR = 2.2; 95%
CI = 1.1–4.5). Physical IPV, reported by 3.6% (n = 26), was associated with antenatal hospitalizations
(134 (19%) vs 11 (42%); AOR = 2.6; 95%CI = 1.0–7.1). Lack of kin support was
associated with spontaneous preterm labour (AOR = 4.7; 95%CI = 1.7–12.8). Mothers with
IPV have higher odds of complications. Obstetricians, gynaecologists and midwives should
act as active screeners, particularly of the undervalued psychological IPV, to reduce or remedy
its effects.