1158: The association between sexual violence history and gynecological and obstetrical behaviors, pregnancy, and delivery outcome

Abstract

Sexual violence is a global public health problem. We aimed to evaluate the association between self-reported history of sexual violence and women's health behaviors, with a focus on routine gynecological and prenatal care practices and outcomes. This was a retrospective questionnaire-based study, including mothers of live singleton newborns delivered at a regional tertiary medical center from October 2018 to February 2019. Participants were asked to answer 4 questionnaires, including screening for sexual violence history (SES), posttraumatic stress disorder (PDS), and postpartum depression (EPDS), as well as demographic and medical history data. Computerized perinatal records were reviewed. Multiple analyses were performed, comparing background and outcome variables across all levels of SES severity. Multivariable regression models were constructed while adjusting for confounders. During the study period, 210 women met the inclusion criteria. Of them, 26.3% (57) reported unwanted sexual encounter victimization, 23% (50) reported coercion, 1.8% (4) assault and attempted rape, and 1.4% (3) reported they were raped. Several multivariate regression models were constructed, to assess the independent association between sexual violence history and delivery mode, perineal damage and EPDS score (Table 1). Sexual violence history was found to be independently and significantly associated with the risk of postpartum depression while adjusting for maternal age, education, and ethnicity (adjusted OR=4.46; 95%CI 2.03-9.81). Exposed women were also more likely to report a negative relationship with their gynecologist and avoid gynecological care (33.9% versus 16.7%, p=0.012). A significant association was found between both positive EPDS screening as well as post trauma and sexual violence history (Table 2). No significant association was found between sexual violence history and pregnancy outcomes. Sexual violence history is extremely common among post-partum women. It is independently associated with post-partum depression, neglected gynecological care, and post trauma.View Large Image Figure ViewerDownload Hi-res image Download (PPT)