Abstract

ObjectivesTo examine the associations of Intimate partner violence (IPV) with stress-related sleep disturbance (measured using the Ford Insomnia Response to Stress Test [FIRST]) and poor sleep quality (measured using the Pittsburgh Sleep Quality Index [PSQI]) during early pregnancy.MethodsThis cross-sectional study included 634 pregnant Peruvian women. In-person interviews were conducted in early pregnancy to collect information regarding IPV history, and sleep traits. Adjusted odds ratios (aOR) and 95% confidence intervals (95%CIs) were calculated using logistic regression procedures.ResultsLifetime IPV was associated with a 1.54-fold increased odds of stress-related sleep disturbance (95% CI: 1.08–2.17) and a 1.93-fold increased odds of poor sleep quality (95% CI: 1.33–2.81). Compared with women experiencing no IPV during lifetime, the aOR (95% CI) for stress-related sleep disturbance associated with each type of IPV were: physical abuse only 1.24 (95% CI: 0.84–1.83), sexual abuse only 3.44 (95%CI: 1.07–11.05), and physical and sexual abuse 2.51 (95% CI: 1.27–4.96). The corresponding aORs (95% CI) for poor sleep quality were: 1.72 (95% CI: 1.13–2.61), 2.82 (95% CI: 0.99–8.03), and 2.50 (95% CI: 1.30–4.81), respectively. Women reporting any IPV in the year prior to pregnancy had increased odds of stress-related sleep disturbance (aOR = 2.07; 95% CI: 1.17–3.67) and poor sleep quality (aOR = 2.27; 95% CI: 1.30–3.97) during pregnancy.ConclusionLifetime and prevalent IPV exposures are associated with stress-related sleep disturbance and poor sleep quality during pregnancy. Our findings suggest that sleep disturbances may be important mechanisms that underlie the lasting adverse effects of IPV on maternal and perinatal health.

Highlights

  • Intimate partner violence (IPV), encompassing physical, psychological and sexual abuse, is a serious public health problem that affects women worldwide

  • Lifetime IPV was associated with a 1.54-fold increased odds of stress-related sleep disturbance and a 1.93-fold increased odds of poor sleep quality

  • Compared with women experiencing no IPV during lifetime, the Adjusted odds ratios (aOR) for stress-related sleep disturbance associated with each type of IPV were: physical abuse only 1.24, sexual abuse only 3.44 (95%confidence intervals (CIs): 1.07–11.05), and physical and sexual abuse 2.51

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Summary

Introduction

Intimate partner violence (IPV), encompassing physical, psychological and sexual abuse, is a serious public health problem that affects women worldwide. A multi-county study indicated that between 20% and 68% of women, aged 15–49 years, reported experiencing sexual and/or physical violence in their lifetime, by a male intimate partner [3]. IPV has been shown to affect women’s physical and mental health, reduce sexual autonomy and increase the overall risk of unintended pregnancies and multiple abortions [2, 4, 5]. Women who report experiencing IPV during pregnancy have elevated odds of adverse reproductive outcomes, including preeclampsia, abnormal vaginal bleeding and spontaneous abortion or miscarriage [2, 5,6,7,8]. Pregnant women experiencing IPV have elevated levels of mood and anxiety disorders [9], hyperarousal and chronic stress [10]

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