Abstract
Background: Intimate partner violence (IPV) affects outcomes of mothers and their offspring. This systematic review collated the worldwide literature on the prevalence rates of different types of IPV in pregnancy.Methods: Two reviewers independently identified cross sectional and cohort studies of IPV prevalence in pregnancy in online databases (PubMed, WOS and Scopus), selected and extracted data [participants' country, study quality, measurement tool (validation and purpose) and rates of IPV in pregnancy]. We considered a high quality study if it had a prospective design, an adequate sampling method, a sample size estimation, a response rate > 90%, a contemporary ascertainment of IPV in the index pregnancy, and a well-developed detailed IPV tool. We performed random effects meta-analysis and explored reasons for heterogeneity of rates.Results: One hundred fifty-five studies were included, of which 44 (28%) met two-thirds of the quality criteria. Worldwide prevalence of physical (126 studies, 220,462 participants), psychological (113 studies, 189,630 participants) and sexual (98 studies, 155,324 participants) IPV in pregnancy was 9.2% (95% CI 7.7–11.1%, I2 95.9%), 18.7% (15.1–22.9%, I2 98.2%), 5.5% (4.0–7.5%, I2 93.4%), respectively. Where several types of IPV were reported combined, the prevalence of any kind of IPV (118 studies, 124,838 participants) was 25.0% (20.3, 30.5%, I2 98.6%). IPV rates varied within and between continents, being the highest in Africa and the lowest in Europe (p < 0.001). Rates also varied according to measurement purpose, being higher for diagnosis than for screening, in physical (p = 0.022) and sexual (p = 0.014) IPV.Conclusions: IPV prevalence in pregnancy varies across countries, with one-quarter of mothers exposed on average globally. Routine systematic antenatal detection should be applied worldwide.Systematic Review Registration: identifier: CRD42020176131.
Highlights
Intimate partner violence (IPV), defined as physical violence, psychological assault and sexual abuse by a current or former intimate partner [1] is an avoidable global public health problem
Prevalence in pregnancy are given in Supplementary Table 2
Worldwide prevalence of physical (126 studies, 220,462 participants), psychological (113 studies, 189,630 participants) and sexual (98 studies, 155,324 participants) IPV in pregnancy was 9.2%, 18.7%, FIGURE 2 | World-wide distribution of intimate partner violence (IPV) types
Summary
Intimate partner violence (IPV), defined as physical violence, psychological assault and sexual abuse (including coercive tactics) by a current or former intimate partner [1] is an avoidable global public health problem. IPV in pregnancy, despite being more common than other obstetric problems like preeclampsia or gestational diabetes [2] remains a neglected condition. It is associated with adverse pregnancy outcomes including increased risk of human immunodeficiency virus infection [3] perinatal depression [4] uterine rupture, hemorrhage, maternal death [5] prematurity, low birth weight, newborns small for gestational age [6] stillbirth [7] insufficient weight gain in pregnancy [8] and reduced levels of breastfeeding [9]. IPV prevalence in pregnancy is reported to vary according to the definition used [1] the measurement strategy [10, 11] and the socio-cultural context of the population studied [2, 12] These factors make comparison between individually reported rates difficult. This systematic review collated the worldwide literature on the prevalence rates of different types of IPV in pregnancy
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