Intimate Partner Violence In Pregnancy Research Articles

Intimate Partner Violence Screening in a Pregnant Military Population: Implementation of the E-HITS Protocol [ID 2683442

INTRODUCTION: The military population has higher rates of intimate partner violence (IPV) compared to the civilian population. This is further exacerbated in obstetrics patients, with an estimated rate of 4–29% of pregnant women affected. The American College of Obstetricians and Gynecologists and 2018 Department of Defense Clinical Practice Guidelines for Management of Pregnancy recommend routine screening for IPV at obstetric visits, although a preferred screening modality has not been identified. METHODS: The prevalence of IPV in pregnancy before and after implementation of the validated Extended-Hurt, Insult, Threaten, Scream (E-HITS) questionnaire at a single military treatment facility was compared. Retrospective chart review was conducted between January and December 2019 of patients who had been screened using a single question (“Do you feel safe at home?”). E-HITS was implemented in the obstetrics clinic in February 2022, and data were collected prospectively for 12 months. The difference between the two IPV screening modalities was analyzed using Fisher’s exact test. RESULTS: A total of 1,627 IPV screenings were reviewed. Of the 783 IPV screenings using the single question, there were 2 positive screens (0.26%). Using greater than 7 as the positive screening cutoff, there were 24 positives (2.84%) out of the 844 E-HITS screenings. Using greater than 6 as the cutoff for E-HITS, there were 54 positive screens (6.4%). There was a statistically significant difference in the detection rate between the two modalities at both cutoff levels (P<.0001). CONCLUSION: E-HITS is a more sensitive screening tool for IPV in this population, more closely mirroring previously published rates.

Identifying Pregnant Patients With Suspected Intimate Partner Violence.

Intimate partner violence (IPV) is the leading cause of death in pregnant women. Although it can be difficult to identify patients experiencing IPV, injuries to the head, neck, or face due to an assault are known to correlate with intentional injury. The objective of this study is to assess the contemporary burden of IPV in pregnancy and describe the patient characteristics. The National Inpatient Sample was queried for all pregnant women between January 2016 and December 2019. Patients were divided into two groups: suspected IPV (SIPV) and no-SIPV groups. We defined SIPV as any pregnant patient with an identified head, neck, or face injuries categorized as intentional assault. Multivariable logistic regression analysis was performed to assess the association between SIPV and variables of interest. A total of 28,540 pregnant patients presented with traumatic injuries with 530 (.02%) identified as SIPV. Suspected IPV patients were younger (25 vs 27 years, P = .012), more likely to be of Black race (46% vs 28%, P = .002), more likely to be in the lowest income quartile (51% vs 38%, P = .031), less likely to have private insurance (12% vs 34%, P < .001), and have higher rates of substance use disorder (35% vs 18%, P < .001). Black race and history of substance use disorder were associated with increased odds of SIPV-related injuries (odds ratio [OR]: 2.01, interquartile range [IQR]: 1.27-3.16, P = .003 and OR: 2.30, IQR 1.54-3.43, P < .001, respectively). Our results suggest that there are significant racial and socioeconomic disparities in potential risk for IPV during pregnancy.

The status of intimate partner violence against pregnant women in contemporary China: a scoping review.

This review explored the status of publications on intimate partner violence (IPV) against pregnant women in contemporary China. The PubMed, Cochrane Library, Embase, CINAHL, and PsycInfo databases were searched using the terms "IPV," "pregnant woman," "Chinese," and synonyms in English, along with related keywords for Chinese publications. All literature pertaining to IPV during pregnancy, conducted in China, and published between 1987 and September 2023 was included. A total of 37 articles from 30 studies were selected. The prevalence of IPV during pregnancy ranged from 2.5% to 31.3%, with psychological violence being the most common form. Frequently identified risk factors included unintended pregnancy, poor family economic conditions, male partners engaging in health risk behaviors, poor employment status of women or their partners, low education levels among women, physical or mental health issues, strained couple relationships, and in-law conflicts. IPV during pregnancy primarily led to mental health problems for the victims and could result in adverse obstetric outcomes, as well as negative effects on the temperament and development of the offspring. Victims in China demonstrated a low willingness to seek help from professionals. Furthermore, relevant research in mainland China is scarce, with a limited number of studies and non-standardized research methodologies. Future research should investigate IPV in pregnancy from various perspectives, identify factors unique to IPV during pregnancy, and focus on high-risk groups. Considering the conditions in China, there is a pressing need to increase public awareness of IPV and to investigate interventions aimed at addressing this issue.

“So that’s why I found PrEP to be safest way to protect yourself”: exploring IPV experiences and impact on HIV prevention among pregnant and postpartum women in Cape Town, South Africa

Intimate partner violence (IPV) occurs at alarmingly high rates towards pregnant women in South Africa. Experiences of emotional, physical, and sexual IPV in pregnancy can adversely impact the health and safety of mother and fetus. Furthermore, IPV is associated with increased risk of HIV, exacerbating the public health impact of violence among pregnant women in this HIV endemic setting. In-depth understanding of cultural and contextual drivers of experiences of IPV is a critical precursor to development of interventions effectively addressing this issue among pregnant women in South Africa. The present study examines factors contributing to IPV among pregnant women to identify potential points of intervention. We conducted twenty in-depth interviews with postpartum women who used oral pre-exposure prophylaxis (PrEP) in pregnancy and reported recent experiences of IPV and/or ongoing alcohol use in a township near Cape Town, South Africa that experiences a heavy burden of both HIV and IPV. Interpretive thematic analysis was used. Several patterns of IPV during pregnancy were identified and violence was frequently described as co-occurring with male partner alcohol use. A majority of women referenced oral PrEP as their preferred method for HIV prevention, highlighting the agency and discretion it provided as beneficial attributes for women experiencing IPV. Fear of judgement from peers for remaining with an abusive partner and a lack of clear community messaging around IPV were identified as barriers to disclosure and support-seeking. Addressing the lack of social support received by women experiencing IPV during pregnancy in South Africa is essential to comprehensive IPV programming.

Mitigating the impact of intimate partner violence in pregnancy and early childhood: A dyadic approach to psychotherapy

AbstractIntimate partner violence (IPV) is often considered an adult problem despite profound consequences for the children who are exposed toviolent relational patterns. About a third of children and adolescents report past exposure to parental IPV, and a majority were first exposed as infants. Exposure to IPV during pregnancy through the first 5 years of a child's life has consequences ranging from adverse birth outcomes to diagnosable emotional problems and lasting physiological dysregulation. This article reviews risks and consequences of IPV in pregnancy and early childhood and discusses a relational psychotherapeutic treatment approach (Child–Parent Psychotherapy) applied to both developmental stages to mitigate the adverse consequences of family violence on parents and their children. Research evidence for the effectiveness of Child–Parent Psychotherapy (CPP) among IPV‐exposed families is reviewed as are specific treatment components which seek to restore relational safety following familial violence. Additionally, clinical considerations unique to families with histories of or ongoing exposure to IPV are discussed. Finally, recommendations are presented to improve the integration between medical and early childhood behavioral health systems for families at highest risk for chronic IPV.

The Exciting Potential for ChatGPT in Obstetrics and Gynecology

ABSTRACT In November 2022, AI Lab OpenAI launched the online chatbot ChatGPT (Chat Generative Pre-Trained Transformer), an accessible language model that uses the artificial intelligence (AI) branch of natural language processing (NLP) to answer prompts based on a library of 175 billion parameters from the “internet, books and other sources.” Because of its ability to answer clinical questions in plain English that can be understood by providers and patients alike, the potential for ChatGPT to be used as a clinical tool is obvious. Despite its impressive fund of source knowledge, these data are potentially biased and unreliable and may not reflect current stances. In addition, ChatGPT does not list sources for its information, and its current capability to answer clinical questions correctly is not well understood. This study aimed to assess answers given by ChatGPT in response to a spectrum of questions about obstetrics and gynecology including systems-level questions, ethical questions, and treatment-related decision making. A total of 14 questions were asked. The first question asked why US preterm birth rates are so high. The second question asked for a list of the most important interventions physicians can do to monitor, prevent, and treat premature births. The third question asked whether vaginal progesterone was effective and safe for preventing preterm birth in women with a short cervix in the midtrimester, and the fourth question asked the same question but in women with a history of preterm birth and no short cervix. The fifth question asked why maternal mortality rates in the United States are so high. The sixth question asked for a list of what obstetricians can do to prevent preeclampsia. The seventh question asked about the safety of hospital births when compared with planned home births in the United States. The eighth question asked whether it is ethically acceptable for an obstetrician to provide emergency cesarean delivery without a woman's informed consent to save the fetus or the mother. The ninth question asked how obstetricians should screen for domestic abuse and intimate partner violence in pregnancy. The 10th question asked if women should freeze their eggs and at what age. The 11th question asked about the risks and benefits of menopause hormone replacement therapy. The 12th question asked how abortion bans in the United States affect women's health and lives. The 13th question asked whether complex hyperplasia atypia surgery should be performed only by a gynecologist-oncologist. The final question asked whether we should continue using the term “pregnant woman” versus alternative including “pregnant person.” Overall, ChatGPT provided nuanced and informed answers to question on virtually any topic in obstetrics and gynecology, but occasionally revealed an apparent lack of insight into the questions being asked. ChatGPT can provide preliminary information about a wide range of topics and can be valuable to both providers and patients and will continue to improve as training data are updated, and the model learns from user prompts.

Exploring the relationship between intimate partner violence during pregnancy and stillbirths

IntroductionThe relationship between intimate partner violence (IPV) in pregnancy and stillbirths is poorly understood. We aimed to determine if there was any association between stillbirths and IPV during pregnancy. MethodsA community-based, matched, case-control study was conducted in 2014, nested within the Maternal and Newborn Health Registry of the Global Network for Women's and Children's Health Research in Pakistan. Using a WHO questionnaire, IPV in pregnancy was ascertained from 256 cases (women with stillbirths) and 539 controls (women with live births), individually matched on parity. Multivariable conditional logistic regression analysis assessed the association of IPV in pregnancy ending in stillbirths compared to those with live births. ResultsThe effect of physical and psychological IPV was modified by maternal age. Among women 25-34 years old with stillbirths, the odds of experiencing physical IPV in pregnancy were four times greater than those with live births, after controlling for confounders [odds ratio 4.1 (95% CI: 1.5, 11.2)]. A negative association was observed between psychological IPV in pregnancy and stillbirths among women younger than 25 years, and no association was observed between sexual IPV during pregnancy and stillbirths. ConclusionStudy results show that women 25-34 years of age with stillbirths were four times more likely to experience physical IPV during pregnancy. Further studies replicating the effect modification of IPV by maternal age are warranted.

Prevalence and patterns of intimate partner violence among antenatal clinic attendees at federal medical center, Abuja.

Intimate partner violence (IPV) has been a source of increasing concern to the government of nations as well as their citizens despite measures taken to reduce it. This is supported by recent data published by the World Health Organization and other development partners. In health care facilities, intimate partner violence in pregnancy has not been screened routinely. Community-based findings have been the source of most data informing policies for decisions. These were to determine the prevalence and patterns of IPV among antenatal clinic attendees at the Federal Medical Center (FMC), Abuja. Following ethical clearance, a health facility-based cross-sectional study was conducted at the FMC, Abuja to determine the prevalence and correlates of IPV during pregnancy among attendees of antenatal clinics. It was conducted between 26th June and 17th September 2021. A total of 450 questionnaires were administered among consecutive consenting clients and 407 were returned filled giving a non-response rate of 9.6%. The questionnaire collected data on respondents' sociodemographics; experience of and types of IPV; and health problems arising from IPV. Results were presented in tables and charts and analysis was done using IBM SPSS (International Business Machines' Statistical product and service solutions) version 25 software. The mean age was 29.37 ± standard deviation 4.43 years and the predominant ethnic group was Igbo (46.5%); 96.56% were married; 68.06% had tertiary education and 49.14% were in their third trimesters. The combined incidence of intimate partner violence among the participants was 17.69% with physical violence contributing 3.19%; the head region (40%) being the most affected body part. While 34% experienced intrauterine foetal death in the past following IPV. In Miller's landmark study, 27 of 1300 sexually active young women, one in five reported partner pregnancy non promoting behaviors, such as intimidation, threats to leave the relationship if the woman did not become pregnant or actual violence. The two most significant factors for IPV were age and marital status both at P values of P = 0.0001. Medical doctors should feel more open discussing issues around IPV with their clients during antenatal visits.

Video Consultations and Safety App Targeting Pregnant Women Exposed to Intimate Partner Violence in Denmark and Spain: Nested Cohort Intervention Study (STOP Study).

Intimate partner violence (IPV) during pregnancy is a public health issue with wide-ranging consequences for both the mother and fetus, and interventions are needed. Therefore, the Stop Intimate Partner Violence in Pregnancy (STOP) cohort was established with the overall aim to identify pregnant women exposed to IPV through digital screening and offer women screening positive for IPV a digital supportive intervention. The aim of this study was to (1) introduce the design and profile of the STOP cohort study, (2) assess the feasibility of implementing digital IPV screening among pregnant women, and (3) assess the feasibility of implementing a digital supportive intervention targeting pregnant women exposed to IPV. Pregnant women attending antenatal care in the Region of Southern Denmark and in Andalucía, Spain were offered digital screening for IPV using validated scales (Abuse Assessment Screen and Women Abuse Screening Tool). Women who screened positive were eligible to receive a digital supportive intervention. The intervention consisted of 3-6 video consultations with an IPV counselor and a safety planning app. In Denmark, IPV counselors were antenatal care midwives trained by a psychologist specialized in IPV, whereas in Spain, the counselor was a psychologist. Data collection started in February 2021 and was completed in October 2022. Across Denmark and Spain, a total of 19,442 pregnant women were invited for IPV screening and 16,068 women (82.65%) completed the screening. More women in Spain screened positive for exposure to IPV (350/2055, 17.03%) than in Denmark (1195/14,013, 8.53%). Among the women who screened positive, only 31.39% (485/1545) were eligible to receive the intervention with only 104 (21.4%) of these women ultimately receiving it. Digital screening for IPV among pregnant women is feasible in an antenatal care context in Denmark and Spain; however, a digital supportive intervention during pregnancy appears to have limited feasibility as only a minor subgroup of women who screened positive for eligibility received the intervention. More research is needed on how to best support pregnant women exposed to IPV if universal IPV screening is to be implemented in antenatal care.

Predictors of Intimate Partner Violence Among Pregnant Women- A Hospital Based Study in Accra, Ghana

Introduction: Intimate partner violence in Pregnancy is a serious, preventable public health problem that affects millions of women worldwide. The term describes physical, sexual, or psychological harm by a current or former partner or spouse. It has been associated with death of both mother and baby in the severest forms of physical intimate partner violence (IPV), ante-partum hemorrhage, placenta abruption, premature birth, small for age babies, fetal injury from maternal trauma, spontaneous abortion, still births among others. There is a dearth of published studies focusing on IPV among pregnant women in Ghana.Methods: This was an unmatched case control study, conducted among pregnant women who visited the Police Hospital for ANC from June to August 2016. We sought to determine the forms of IPV among cases, and identify the associated risk factors.Results: All three forms of IPV were represented. There was no statistically significant difference between the means of ages of the cases and controls, age of their partners, and duration of relationship. In bivariate analysis, mothers were less likely to be victims of IPVif they had tertiary education, had salaried work or were nulliparous and also if their partners were salaried. They were more likely to be victims of IPV if they took alcohol and if their partners also took alcohol. In the multivariate analysis, however, only partner’s alcoholintake was a significant predictor of IPV (AOR 2.12, p value 0.009).Conclusions: Alcohol use by the partner could be used to screen for IPV among pregnant women in a hospital setting

Trajectories and predictors of perinatal depressive symptoms among Kenyan women: a prospective cohort study

There are gaps in understanding longitudinal patterns and predictors of perinatal depressive symptoms in sub-Saharan Africa. This study aimed to explore trajectories of depressive symptoms and associated factors from pregnancy to 9 months post partum among Kenyan women. In this prospective cohort study, we analysed data from the PrEP Implementation for Mothers in Antenatal Care (PrIMA) study in which HIV-negative women were enrolled in pregnancy and followed up to 9 months post partum in 20 public sector maternal-child health clinics in western Kenya. Pregnant women were eligible for enrolment if they were not infected with HIV, aged 15 years or older, and were able to provide consent. Eligible participants were screened and enrolled between Jan 15, 2018, and July 31, 2019, and followed up to 9 months post partum, with the last participant study visit conducted on Jan 15, 2021. Study nurses serially assessed depressive symptoms using the Center for Epidemiologic Studies Depression Scale (CESD-10), intimate partner violence with the Hurt, Insult, Threaten, Scream scale, and social support with the Medical Outcomes Study scale. Generalised estimating equations were used to identify correlates of moderate-to-severe depressive symptoms (CESD-10 score ≥10) and group-based trajectory modelling identified discrete trajectories of perinatal depressive symptoms. Among 4447 participants in the main PrIMA study, 3555 had complete depressive symptom data in pregnancy and depressive symptom data post partum and were included in the primary analysis. Median age was 24·0 years (IQR 21·0-28·7), 1330 (38%) participants had low social support, and 278 (8%) reported intimate partner violence in pregnancy. All participants (100%) were female and all (100%) were of African Kenyan ethnicity. Prevalence of moderate-to-severe depressive symptoms was higher in pregnancy than post partum (870 [24·5%; 95% CI 23·1-25·9] vs 597 [6·8%; 15·6-18·1]; p<0·0001). Five patterns of depressive symptoms were identified; persistent moderate-to-severe depressive symptoms in pregnancy and post partum (295 [8·3%]), moderate-to-severe depressive symptoms in pregnancy that resolved post partum (139 [3·9%]), moderate-to-severe depressive symptoms that emerged post partum (40 [1·1%]), chronically mild symptoms (2709 [76·2%]), and no depressive symptoms (372 [10·5%]). Emergent moderate-to-severe depressive symptoms were associated with older age. Emergent, persistent, and resolving moderate-to-severe depressive symptoms were associated with intimate partner violence during pregnancy; and persistent and resolving moderate-to-severe depressive symptoms were associated with low social support and high HIV risk (all p<0·05). Moderate-to-severe depressive symptom risk was significantly increased with intimate partner violence (adjusted odds ratio 2·07 [95% CI 1·81-2·31]; p<0·0001), low social support (1·74 [1·56-1·95]; p<0·0001), and partner HIV-positive status (1·48 [1·22-1·78]; p<0·0001). 23·34% (95% CI 18·77-27·65) of cases of perinatal moderate-to-severe depressive symptoms were attributable to low social support. One third of women had perinatal moderate-to-severe depressive symptoms; nearly half of these had higher severity phenotypes of resolving, persistent, and emerging moderate-to-severe depressive symptoms that might require tailored interventions. Perinatal women with comorbid psychosocial stressors such as intimate partner violence and previous pregnancy loss should be prioritised for mental health services that augment social support within routine maternal-child health care. National Institutes of Health. For the Kiswahili translation of the abstract see Supplementary Materials section.

Factors associated with experiencing lifetime intimate partner violence among pregnant displaced women living in refugee camps in Erbil, Iraq

ABSTRACT According to the World Health Organization, intimate partner violence (IPV) affects 35% of women worldwide and 40% of pregnant women, often resulting in maternal and infant death and harm. Displaced persons are at higher risk of abuse compared to the general population. While few studies have explored IPV in Iraq, research from Erbil, Iraq showed nearly 60% of women reported experiencing IPV in their lifetime. No publications examining IPV among displaced women in Iraq exist. Considering the severe impacts of IPV in pregnancy and the associated risks for IPV among women in refugee camps, this paper presents the first analysis of prevalence and factors associated with lifetime IPV among displaced pregnant women in two Iraqi refugee camps. Thirteen percent of women reported experiencing any abuse and experiencing IPV was associated with receiving fewer years of schooling (p = 0.04), not having a private doctor (p = 0.002), attending the first prenatal visit during the third trimester (p = 0.03), feeling pressure to have a child (p = 0.003), knowing someone who was physically injured by their husband (p = 0.05), experiencing suicidal ideation (p = 0.02), and being worried about harming one's baby (p = 0.02). Policy and programme recommendations for screening and prevention of IPV in resource-limited settings are provided.

Adverse birth outcomes among women exposed to intimate partner violence in pregnancy in Ikere-Ekiti, South-west Nigeria: A prospective cohort study

ObjectiveStudies on birth outcomes associated with intimate partner violence in pregnancy in Nigeria are scarce. We aimed to evaluate adverse birth outcomes among women exposed to intimate partner violence in pregnancy in a Nigerian population. Study DesignWe performed a prospective cohort study involving 363 women with singleton pregnancies presenting for antenatal care between March 2019 and September 2019. Intimate partner violence was assessed with a validated self-administered questionnaire- ongoing abuse screen. We compared adverse birth outcomes between women that experienced intimate partner violence in pregnancy and those that did not. Multivariate logistic regression was used to adjust for confounders. ResultsOf the 363 pregnant women that completed the study, 56(15.4%) experienced intimate partner violence in pregnancy. Women who experienced intimate partner violence in pregnancy were significantly more likely to experience composite adverse birth outcome (53.6% compared with 20.2%,adjusted OR 4.72, 95% CI: 2.43–9.19, p < 0.001) preterm delivery (26.8% compared with 13.4%,adjusted OR 2.96, 95% CI: 1.34–6.50, p = 0.007), stillbirths(17.9% compared with 3.3%,adjusted OR 9.52, 95% CI: 3.96–22.90, p < 0.001) and neonatal intensive care unit admission (32.1% compared with 19.9%, adjusted OR 1.93, 95% CI: 1.19–10.60, p = 0.03). Mode of delivery and low birth weight did not differ significantly between the two groups. ConclusionIntimate partner violence is associated with increased risk of preterm delivery, stillbirth and neonatal intensive care unit admission. There is a need to evaluate the effect of interventions on these adverse birth outcomes.

Intimate partner violence and growth outcomes through infancy: A longitudinal investigation of multiple mediators in a South African birth cohort.

Intimate partner violence (IPV) has been linked to poor fetal and infant growth. However, factors underlying this relationship are not well understood, particularly in the postnatal time period. In a South African cohort, we investigated (1) associations between IPV in pregnancy and growth at birth as well as postnatal IPV and child growth at 12 months and (2) whether maternal depression, tobacco or alcohol use or infant hospitalizations mediated IPV‐growth relationships. Mothers were enrolled in pregnancy. Maternal IPV was measured during pregnancy and 10 weeks postpartum; depression, alcohol and tobacco use were measured during pregnancy and at 6 months postpartum. Child weight and length were measured at birth and 12 months and converted to z‐scores for analysis. Linear regression and structural equation models investigated interrelationships between IPV and potential mediators of IPV‐growth relationships. At birth, among 1,111 mother–infant pairs, maternal emotional and physical IPV were associated with reduced weight‐for‐age z‐scores (WFAZ). Only physical IPV was associated with length‐for‐age z‐scores (LFAZ) at birth. Antenatal maternal alcohol and tobacco use mediated IPV‐growth relationships at birth. Postnatally, among 783 mother–infant pairs, emotional and physical IPV were associated with reduced WFAZ at 12 months. Only emotional IPV was associated with LFAZ at 12 months. Maternal tobacco use was a mediator postnatally. Findings highlight the role of physical and emotional IPV as risk factors for compromised fetal and infant growth. Findings underscore the importance of programmes to address interrelated risk factors for compromised infant growth, specifically IPV and substance use, which are prevalent in high‐risk settings.

Worldwide Prevalence of Intimate Partner Violence in Pregnancy. A Systematic Review and Meta-Analysis.

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.

Prevalence of Intimate Partner Violence in Pregnancy: An Umbrella Review.

Background: Intimate partner violence (IPV) is a public health concern, especially during pregnancy, and needs to be urgently addressed. In order to establish effective actions for the prevention of IPV during pregnancy, authorities must be aware of the real burden of IPV. This review aimed to summarize the existing evidence about IPV prevalence during pregnancy worldwide. Methods: A review of reviews was carried out. All published systematic reviews and meta-analyses published until October 2020 were identified through PubMed, Scopus, and Web of Science. The main outcome was the IPV prevalence during pregnancy. Results: A total of 12 systematic reviews were included in the review, 5 of them including meta-analysis. The quality of the reviews was variable. Physical IPV during pregnancy showed a wide range (1.6–78%), as did psychological IPV (1.8–67.4%). Conclusions: Available data about IPV prevalence during pregnancy were of low quality and showed high figures for physical and psychological IPV. The existing evidence syntheses do not capture the totality of the worldwide disease burden of IPV in pregnancy.

Intimate partner violence among obstetric population at university of Abuja teaching hospital, Abuja, Nigeria.

Perpetrators of intimate partner violence (IPV) did not spare pregnant women despite their physiological and anatomical changes in pregnancy. The epidemiology and outcomes of IPV change with time in the society. The objective of the study was to determine the prevalence of and risk factors associated with IPV among pregnant women attending antenatal clinic. This was a cross-sectional, hospital-based study conducted at the Antenatal Clinic of the Department of Obstetrics and Gynaecology, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria. This study involved 403 pregnant women. The Hurt, Insult, Threaten and Scream (HITS) questionnaire was used to collect information and data recorded and analysed using SPSS version 23. Descriptive and inferential statistics (Chi-squared, Fisher's test and logistic regression) were used. Level of significance was set at P < 0.05. The prevalence of IPV in pregnancy was 56.3% and the modal score was 4. About 11.9% of the women had a positive (severe) HITS score while 38.4% of the women experienced insult as the most common form of violence. There was a statistically significant association between the level of the score and marriage settings (P < 0.001), education of the woman (P < 0.001), education status of the husband (P < 0.001), occupation of the woman (P < 0.001), occupation of the husband (P < 0.001) and social habit of the husband (P < 0.001). The prevalence of IPV was high from this study. Improvement in education status of the husband and employment status of both the wife and the husband can significantly affect violence against women positively in our society.

Intimate Partner Violence During Pregnancy and Risk of Fetal and Neonatal Death: A Meta-analysis With Socioeconomic Context Indicators

(Am J Obstet Gynecol. 2020;222:123.e5–133.e5) It is estimated that 30% of women have experienced intimate partner violence (IPV) during their lifetime. IPV in pregnancy can cause both immediate (uterine rupture, fetal and maternal death) and long-term sequelae (low birthweight and prematurity) that are associated with increased risk of fetal and neonatal death. While maternal conditions, such as psychosocial stressors, infectious diseases, and environmental exposures, have been shown to impact fetal and neonatal health, the association between IPV and fetal and neonatal mortality has not been studied comprehensively. This study aimed to summarize the results of observational studies investigating the risk of perinatal death as a direct function of IPV as well as examine how socioeconomic factors may influence this association.

Ethiopian Health Care Workers' Insights into and Responses to Intimate Partner Violence in Pregnancy-A Qualitative Study.

Violence against women is a global pandemic, with the potential to spread through generations. Intimate partner violence has impacts on women’s sexual, reproductive, and psycho-social health. It can occur during pregnancy and adversely affect the health of both mother and child. Health care workers involved in antenatal care can have a unique role in identifying intimate partner violence and in intervening, preventing, and mitigating its consequences. In this study, the objective was to explore Ethiopian health care workers’ insights of and responses to intimate partner violence in pregnancy. Using an exploratory design, this qualitative study includes ten semi-structured interviews of health care workers representing different antenatal care centers in Jimma, Ethiopia. The content analyses of translated interview notes were conducted with Atlas.ti7 software, (Atlas.ti Scientific Software Development Gmbh, Berlin). The health care workers shared their insights of the consequences of intimate partner violence during pregnancy in addition to their experience with and responses to the victims. There was a limited understanding of the extent of the adverse impacts of intimate partner violence on pregnancy outcomes, as well as the potential long-term health implications. The informants described how they only gave medical treatment for obstetric complications or visible trauma during pregnancy. There was no formal referral to or linkages with other resources. Women’s empowerment and systemic changes in the health care, including training and capacity building, clear guidelines addressing management of intimate partner violence in pregnancy, and inclusion of intimate partner violence screening tools in the Ethiopian antenatal care chart/card, were recommended by the informants. The adverse impacts of intimate partner violence on pregnancy outcomes were poorly understood by the Ethiopian health care workers in this study. They offered limited assistance to the victims and recommended changes in the routine antenatal care (ANC) and health care systems. They identified various policy initiatives focusing on women’s empowerment to reduce intimate partner violence and its complications especially during pregnancy.

Intimate Partner Violence in Pregnancy: Knowledge and Experiences of Pregnant Women and Controlling Behavior of Male Partners in Sokoto, Northwest Nigeria.

Background Violence against women perpetrated by an intimate partner is an important public health issue. In recent years, attention has focused also on intimate partner violence (IPV) during pregnancy due to its prevalence, adverse health consequences, and intervention potentials. Aim To determine the knowledge, experiences, and factors influencing IPV, including the controlling behaviors of male partners of pregnant women attending an antenatal clinic (ANC) of a tertiary health facility in Sokoto. Materials and method. A descriptive cross-sectional study was conducted among 260 pregnant women attending ANC in a tertiary health facility in the Sokoto metropolis. They were selected using a systematic sampling technique, and a set of pretested questionnaire items was used for data collection. Data were analysed using IBM SPSS version 20. Results The respondents' ages ranged from 19 to 40 years with a mean of 29.09 ± 4.99 years, and up to 83.5% of them were in a monogamous setting. Three-quarters of them were Muslims mostly from urban areas (72.1%), and 36.4% had a university or HND degree. Majority of them responded correctly to questions on IPV; overall, up to 99.2% of them had good knowledge of IPV. About 33% of the respondents have experienced IPV while pregnant and up to 61.7% of them said they did nothing because of fear. Some of the controlling behaviors of male partners included always asking for permission before seeing friends and family members and also controlling their finances. Factors associated with IPV include tribe, place of residence, and partner consuming alcohol. Conclusion Majority of the respondents had good knowledge of IPV with about one-third of them ever experiencing it. Respondent's partners were mostly jealous and exhibited some form of controlling behaviors. Physical violence was the most prevalent form, and most of the victims did nothing about it. Government and women's right groups should push for the implementation of tougher punitive measures against perpetrators of IPV.