Abstract
BackgroundViolence against women by their male intimate partners (IPV) during pregnancy may lead to negative pregnancy outcomes. We examined the role of IPV as a potential risk factor for miscarriage in Guatemala. Our objectives were: (1) To describe the magnitude and pattern of verbal, physical and sexual violence by male intimate partners in the last 12 months (IPV) in a sample of pregnant Guatemalans; (2) To evaluate the influence of physical or sexual IPV on miscarriage as a pregnancy outcome.MethodsAll pregnant women reporting to the maternity of a major tertiary care public hospital in Guatemala City from June 1st to September 30th, 2006 were invited to participate in this cross-sectional study. The admitting physician assessed occurrence of miscarriage, defined as involuntary pregnancy loss up to and including 28 weeks gestation. Data on IPV, social and demographic characteristics, risk behaviours, and medical history were collected by interviewer-administered questionnaire. Laboratory testing was performed for HIV and syphilis. The relationship between IPV and miscarriage was assessed through multivariable logistic regression.ResultsIPV affected 18% of the 1897 pregnant Guatemalan women aged 15-47 in this sample. Verbal IPV was most common (16%), followed by physical (10%) and sexual (3%) victimisation. Different forms of IPV were often co-prevalent. Miscarriage was experienced by 10% of the sample (n = 190). After adjustment for potentially confounding factors, physical or sexual victimisation by a male intimate partner in the last 12 months was significantly associated with miscarriage (ORadj 1.1 to 2.8). Results were robust under a range of analytic assumptions.ConclusionsPhysical and sexual IPV is associated with miscarriage in this Guatemalan facility-based sample. Results cohere well with findings from population-based surveys. IPV should be recognised as a potential cause of miscarriage. Reproductive health services should be used to screen for spousal violence and link to assistance.
Highlights
Violence against women by their male intimate partners (IPV) during pregnancy may lead to negative pregnancy outcomes
For the 1897 women included in the study, the following reasons for presenting to the Hospital General San Juan de Dios (HGSJD) maternity were recorded by the admitting physicians: labour (n = 783, 41.28%), pregnancy complications (n = 581, 30.63%), false labour (n = 228, 12.02%), miscarriage (n = 194, 10.23%), risk of miscarriage, (n = 99, 5.22%), and induced abortion (n = 12, 0.63% (12 women))
Interpretation There is substantial evidence that physical and sexual Intimate partner violence (IPV) is associated with miscarriage in this Guatemalan facility-based sample
Summary
Violence against women by their male intimate partners (IPV) during pregnancy may lead to negative pregnancy outcomes. Violence against women by their male intimate partners (IPV) has a direct impact on the survival and quality of life of women and children worldwide. It is increasingly recognised as an important determinant of women’s health and well being and, when it occurs during pregnancy, of poor birth outcomes [1,2,3]. Miscarriage is the most common negative gestational outcome occurring in about 20% of clinically recognised pregnancies [12]. General studies of the determinants of miscarriage have typically not considered IPV [13]
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