Abstract
Intimate Partner Violence (IPV) is a major public health issue, including during pregnancy where it poses a serious risk to the woman’s health. Influenza-Like Illness (ILI) also causes significant morbidity for women during pregnancy. It may be possible that ILI in pregnancy is associated with IPV, and that depression and trauma history play a role in the connection. 524 Australia-born women and 578 refugee-background women participated in the study. Baseline participants were randomly recruited and interviewed from antenatal clinics between January 2015 and March 2016, and they were reinterviewed six months post-partum. Bivariate and path analysis were used to assess links between IPV, depression and ILI. One in 10 women (10%; 111 out of 1102) reported ILI during their pregnancy period and this rate was significantly (p < 0.001) higher for women born in conflict-affected countries (13%; 76 out of 578) as compared to Australian-born women (7%; 35 out of 524). In both groups, Time 1 traumatic events, IPV and depression symptoms were significantly associated with ILI at Time 2. A significant association between IPV at Time 1 and ILI at Time 2 was fully mediated by depression symptoms at Time 1 (Beta = 0.36 p < 0.001). A significant direct path was shown from depression symptoms to ILI (Beta = 0.26, p < 0.001). Regardless of migration history, pregnant women who have experienced IPV and depression are more likely to report influenza-like symptoms in pregnancy. This may suggest that trauma and depression negatively affect immunity, although it could also indicate a connection between depressive symptoms and physical experiences of ILI.
Highlights
We examined a theoretical relationship between exposure to Intimate Partner Violence (IPV) during pregnancy, association with trauma events and depression symptoms, and reporting of Influenza-Like Illness (ILI)
We postulated that IPV exposure from the current or previous partner measured at Time 1 would be associated with reports of ILI during pregnancy, which we evaluated at Time 2, approximately 6 months after the birth of the child
Of 1574 eligible women recruited at the time of first appointment in the antenatal clinic, 1335 were interviewed at baseline (84.8% response rate), including 650 women born in Australia (48.7%) and 685 from conflict-affected countries (51.3%)
Summary
Intimate Partner Violence (IPV) is a form of trauma that is associated with common mental disorders and can lead to physical injury, illness, and mortality [1,2]. The prevalence and pathways between IPV and Influenza-Like Illness (ILI) remain unexplored, including during the high-risk antenatal period where IPV is acknowledged to increase in frequency [3]. Before COVID-19, ILI, a term commonly used to describe an acute respiratory illness with fever that has not been laboratory proven, caused more morbidity and mortality than any other infectious disease in Australia, UK or the USA [4]. ILI can cause a primary viral or secondary bacterial pneumonia, and pre-existing chronic diseases
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