Poor antenatal care attendance is associated with intimate partner violence: Multivariate analysis of a pregnancy cohort

Abstract

ObjectiveIntimate partner violence (IPV) is a common, neglected public health problem and pregnancy is a period of vulnerability. We evaluated the relationship of attendance for antenatal care with the experience of psychological and physical IPV. Study designWe established a cohort of 779 consecutive mothers who received antenatal care and gave birth in 15 public hospitals, Andalusia, Spain. 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; cut-offs: physical IPV = 10, psychological IPV = 25). Less than eight visits defined the threshold for poor antenatal care attendance. Multivariate logistic regression estimated crude (COR) and adjusted odds ratios (AOR), with 95% confidence intervals (CI), of the relationship between antenatal care attendance and psychological and physical IPV, controlling for socio-demographic and other pregnancy characteristics. ResultsResponse rate was 92.2%. Poor antenatal clinic attendance, observed in 76 (9.8%) women, was associated with both physical IPV (n = 26, 39% vs 9%; COR = 6.2, 95%CI = 2.7–14.3; AOR = 3.3, 95%CI = 1.1–9.4) and psychological IPV (n = 149, 20% vs 8%; COR = 2.9, 95%CI = 1.7–4.8; AOR = 1.6, 95%CI = 0.9–3.1), though the latter was not significant in multivariate analysis. ConclusionWomen with a poor antenatal care attendance have higher risk of suffering physical IPV during pregnancy. Clinicians should be vigilant about the risk of IPV in mothers with poor attendance for antenatal care.