Violence In Pregnancy Research Articles

Predictor Role of Intimate Domestic Violence During Pregnancy and Mental Health in Maternal Competency with Moderating Role of Motherinfant Attachment: A Structural Equation Model

Introduction: Intimate domestic violence causes psychological consequences in pregnancy and maternal competency. We aimed to assess the effect of domestic violence on mental health and maternal competency with the moderating role of mother-infant attachment behavior. Methods: This prospective longitudinal study was conducted on 254 primiparous mothers in the third trimester of pregnancy referring to selected health centers in Qazvin province, Iran. Data collection tools were questionnaires. Data were analyzed by SPSS and Smart Partial Lease Square3 software. Results: The results of the structural equations model showed that domestic violence has a positive and significant effect on mental health disorders (β = 0.87). Mental health disorder has a negative and significant effect on parental acceptance (β = -0.55). Domestic violence has a negative and significant effect on mother-infant attachment behavior (β = -0.83), also mother-infant attachment behavior is a moderator of the relationship between pregnancy violence and maternal competency (T-value = 3.17). Conclusion: The results revealed that domestic violence during pregnancy affects the mental health of pregnant mothers and maternal competency and mother-infant attachment behavior moderates this relationship. Therefore, it is recommended that mothers facing domestic violence be identified and receive psychological support and counseling, and also improve maternal competence and mother-infant attachment behavior in mothers exposed to violence.

Profiling intimate partner violence in booked pregnant women at Alex Ekwueme Federal University Teaching Hospital Abakaliki and associated puerperal depressive sequelae: a prospective cohort study

BackgroundIntimate partner violence (IPV) in pregnancy is a physical, sexual, psychological or economic harm by a current or former partner or spouse on a pregnant woman. It is a global public health problem that is common but underreported. Women are at increased risk of psychiatric illness in pregnancy and after delivery with the risk of major depressive disorder being highest during the postpartum period. Intimate partner violence in pregnancy may worsen this problem.ObjectivesThe objectives of the study were to determine the prevalence of intimate partner violence (IPV) in pregnancy, incidence of postpartum depression and the relationship between intimate partner violence, delivery outcomes and postpartum depression among booked pregnant women at Alex Ekwueme Federal University Teaching Hospital Abakaliki, Ebonyi state, Nigeria (AEFUTHA).Study designThis study was a prospective cohort study.SettingThe antenatal clinic, antenatal ward, labour ward, postpartum clinic and under five clinic of Alex Ekwueme Federal University Teaching Hospital Abakaliki, Ebonyi state, Nigeria were used for the study.Method One hundred and thirty-seven booked pregnant women that received antenatal care at AEFUTHA who met the inclusion criteria and consented to the study, were recruited from 37 weeks to 41 weeks gestation and screened for intimate partner violence and depression. Those with depression were referred for treatment while those that met the inclusion criteria were followed up to delivery and the delivery outcomes documented. They were also followed up to six weeks postpartum when they were screened for postpartum depression. Data were collated, tabulated and then statistically analysed using Statistical Package for Social Science (SPSS) software (version 25, Chicago II, USA). Numerical variables including participant’s age, parity and gestational age were presented as mean, median, frequencies and standard deviation (Mean ± S.D), while categorical variables including occupation, level of education, social class and family type were presented as numbers and percentages. Chi-square test (X2) and relative risk was used for comparison between groups for categorical variables while Fisher’s exact test was used when Chi-square test (X2) was not suitable. Binary regression analysis was used to determine the relationship between intimate partner violence and postpartum depression. A P value of ˂0.05 is considered statistically significant.ResultsThe prevalence of intimate partner violence was 52.6%, as 72 out of the 137 women recruited endured intimate partner violence. The major risk factors for intimate partner violence in the study were low level of education, low social class, polygamy and unemployment. The general incidence of postpartum depression was 29.93% while the incidence among women with intimate partner violence was 56.94%. Women with emotional violence and verbal abuse had a five-fold increase in the incidence of postpartum depression. Sexual violence and physical violence were not statistically significant risk factors for postpartum depression.ConclusionIntimate partner violence is common as seen from the study. It is a significant risk factor for postpartum depression. Women that are emotionally and verbal abused are more likely to have postpartum depression. Screening pregnant women for intimate violence may identify those at risk and allow for proper interventions.

Intimate partner violence among pregnant women attending a low-resource primary care facility in Ghana.

Intimate partner violence in pregnancy is a significant public health issue that has several detrimental effects. Pregnant women subjected to intimate partner violence (IPV) have a higher risk for adverse pregnancy outcomes. The aim of the study was to determine the prevalence, patterns and factors associated with intimate partner violence among pregnant women attending a primary care antenatal clinic. A quantitative cross-sectional study design was employed to study intimate partner violence among 269 pregnant women in Accra, Ghana between July and October 2021. Participants were selected by systematic sampling technique. The self-reported Composite Abuse Scale was used to assess and classify intimate partner violence. Socio-demographic, clinical (obstetric) and behavioural characteristics were obtained with a structured questionnaire. Associations were determined between independent and dependent variables using the chi-squared test, and logistic regression with adjusted odds ratio (AOR). The statistical significance level was set at a p-value ≤ 0.05. The prevalence of IPV was 11.2%. The prevalence of emotional/psychological abuse, harassment/controlling behaviour, physical abuse, sexual abuse and severe combined abuse were 12.3%, 13.0%, 8.2%, 3.3% and 8.9% respectively. Pregnant women who were employed had reduced odds of experiencing IPV [AOR = 0.16 (95%CI: 0.05-0.47), p = 0.001], however, the past experience of violence [AOR = 4.9 (95%CI: 1.06-22.96), p = 0.042], alcohol use by women [AOR = 7.8 (95%CI: 1.63-37.42), p = 0.01], and partners' alcohol consumption [AOR = 10.0 (95%CI: 3.22-31.26), p<0.001] were associated with increased odds of IPV. There is a high prevalence of IPV among pregnant women in this study from a resource-limited setting. The factors found to be associated with IPV in pregnancy were the employment status of women, alcohol consumption by women or their partners and a previous history of violence. Healthcare providers in primary care need to recognize IPV as a medical condition that can occur in pregnancy and be ready to assist and manage the victims when it is detected.

Risk of adverse perinatal outcomes with violence in pregnancy.

To examine the association between physical, sexual, or physiological harm in pregnancy and perinatal outcomes in a large, contemporary birth cohort. This retrospective cohort study used California-linked vital statistics and hospital discharge data from 2016 to 2020. We included singleton, non-anomalous births with a gestational age of 23-42weeks. Violence in pregnancy was identified using International Classification of Disease, Tenth Revision (ICD-10) codes. Chi-square tests and multivariable Poisson regression models were used to evaluate associations of violence in pregnancy with perinatal outcomes. A total of 1,728,478 pregnancies met inclusion criteria, of which 3,457 (0.2%) had reported violence in pregnancy. Compared to those without violence in pregnancy, individuals who experienced violence had an increased risk of non-severe hypertensive disorders (aRR = 1.36, 95% CI 1.22, 1.51), preeclampsia with severe features (aRR = 1.34; 95% CI 1.11, 1.61), chorioamnionitis (aRR = 1.68; 95% CI 1.48, 1.91), anemia (aRR = 1.59; 95% CI 1.50, 1.68), antepartum hemorrhage (aRR = 2.17; 95% CI 1.19, 3.95), and postpartum hemorrhage (aRR = 1.65; 95% CI 1.48, 1.85). Violence in pregnancy was also associated with increased risk of Apgar score < 7 at 5 min (aRR = 1.37; 95% CI 1.11, 1.71) and neonatal hypoglycemia (aRR = 1.26; 95% CI 1.07, 1.48). Violence experienced in pregnancy is associated with an increased risk of adverse perinatal outcomes. Understanding how universal screening and early recognition of violence in pregnancy may reduce disparities in maternal morbidity for this understudied population is critical.

Domestic Violence in Pregnancy during the Pandemic Era: a Systematic Review

Domestic Violence in Pregnancy during the Pandemic Era: a Systematic Review

Domestic Violence in Pregnancy during the Pandemic Era: a Systematic Review.

Women, and mainly pregnant ones, have been always highly vulnerable to domestic violence/intimate partner violence (DV/IPV) throughout their lives. Covid-19 pandemic brought new unprecedented living conditions that raised the rates of DV during pregnancy. Investigating the association between Covid-19 and DV in pregnant women may help government and community groups seeking to reduce DV/IPV in vulnerable populations in order to better understand the prevalence of this phenomenon and its associated factors and thus find ways to ensure control and stop domestic violence, as the society and health care systems are still disorganized in the way they deal with the DV against pregnant women. The aim of this study is to investigate the state of DV in pregnant women during the Covid-19 pandemic and to present the incidence rates of domestic violence as well as the possible consequences that can occur for both women and newborns, while also highlighting risk factors connected to Covid-19 that increase DV and attempting to see if there is a way to prevent and address DV through a systematic review of the available literature. We searched Google Scholar, Medline and PubMed for relevant articles published between 2019-2023. Out of the total number of 772 returned articles, only 25 were included in the present review after excluding all those which failed to meet one of the critical criteria. We identified four themes linked to DV during pregnancy in the pandemic era, including the incidence of negative consequences for mother and fetus, Covid-19-associated factors, interventions and solutions. Also, prevalence of DV was found to be higher than before the pandemic. DV/IPV was linked to Covid-19 factors such as lockdown and quarantine, causing spouses to spend more time together, economic strains from loss of incomes and reduced incomes, unintended pregnancies and limited access to healthcare services for antenatal and prenatal clinics and support. The adverse effects of DV/IPV on pregnant women and the fetus include miscarriages, still births, abortions, early fetal loss, maternal anxiety and depression as well as poor development of the child after birth, among others. Critical interventions to manage DV/IPV during the pandemic include, to name just a few, better screening systems during the pandemic, public awareness, maintenance of support and healthcare systems and connections. Covid-19 created circumstances and measures that increased the risk and incidence of DV/IPV in pregnant women, which led to a higher prevalence of the phenomenon. Sustainable systems can help reduce DV/IPV against women and, in particular women at-risk, such as pregnant ones. Therefore, some interventions, including screening mechanisms and public awareness, healthcare support and interconnections, need to be maintained and strengthened during times of crisis, such as the pandemic, to curb mitigate DV/IPV.

COVID 19 and violence in Pregnant women: A short review

Introduction: COVID 19 pandemic made pregnant women more likely to experience domestic violence due to its unique circumstances and the unpreparedness of the health care systems. Event that led to increased episodes of violence. Purpose: This review aims to investigate the relationship between COVID-19 and violence in pregnancy. Methodology: Recent articles between the period 2019 to 2023 were included after searching Medline, Pubmed and Google Scholar. Results: The results spotted out that COVID-19 increased the prevalence of domestic violence comparatively to the period before the Pandemic due to lockdown which led the couples spending more time together and the lowest incomes. It also showed that there were negative impacts in both pregnant women and fetus, such as miscarriages and psychological impacts to women. While highlighted the need of better organized health care systems and public awareness. Conclusions: Public awareness and more supportable health care systems could help in the early recognition of pregnant women at risk and reduce the phenomenal of violence during pregnancy.

Epidemiology of violence against young children in Jamaica

ABSTRACT Violence against young children is known to have detrimental short and long-term effects. Yet, few studies investigate the prevalence of violence against young children, particularly very young children under the age of 2 years. This paper reports on the prevalence of violence against young children in Jamaica using data obtained from the JA KIDS birth cohort study that undertook pre-enrolment of pregnant mothers in the antenatal period and followed full or sub-samples of parents and children at 9–12 months, 18–22 months and 4–5 years. Violence in pregnancy was experienced by 6.1% of pre-enrolled mothers. As many as 43.1% of Jamaican children ages 9–12 months were shouted at, and almost 30% were slapped. Physical and emotional violence increased with age, and by 4–5 years, approximately 90% of children experienced physical and emotional violence. Non-violent methods, primarily explaining and reasoning with children, were also reported by more than 95% of parents at 4–5 years. Corporal punishment was the most common form of violence experienced, but young children also witnessed hurtful physical and emotional violence between mothers and their partners and lived in communities in which there were violent events. Strategies to reduce young children’s experiences as victims and witnesses of violence are discussed.

Educational training programs on intimate partner violence in pregnancy for midwives/student midwives: A scoping review.

Educational strategies for preventive screening and effective interventions in midwives are needed to improve clinical practice and outcomes for abused women and their families. This scoping review aimed to describe available educational training programs on intimate partner violence (IPV) in pregnancy for midwives/student midwives. A scoping review of the literature, which was published in English from January 2010 to March 2023, in PUBMED, EBSCO, and CINAHAL databases, was applied. The following keywords were used in the search: 'evaluation', 'educational training', 'course', 'midwives', 'student midwife', 'intimate partner violence', 'pregnancy', combined with AND and OR Boolean operators. The included studies focused on training programs/courses for midwives/student midwives regarding intimate partner violence. A total of 9 studies were eligible for inclusion, describing six programs for midwives and 3 for student midwives. Educational interventions varied in length (e.g. a few hours to weeks) and educational approaches such as multidisciplinary sessions, lectures, theory, role-playing, practice in screening, group activities, watching videos, and case reports discussion. The programs had similar content, including raising awareness of violence, defining it, discussing gender roles, the impact of IPV on women's health, referral agencies, and the laws regarding violence in each country. This scoping review highlighted a lack of educational programs on intimate partner violence during pregnancy, suggesting that new programs need to be developed based on contemporary clinical practices and recommendations for midwifery education.

Frequency of domestic violence in pregnancy and its adverse maternal outcomes among Pakistani women.

To determine the frequency of domestic violence in pregnancy and its adverse maternal outcomes among Pakistani women. This was a prospective descriptive longitudinal study conducted at the Department of Obstetrics & Gynecology of Jinnah Postgraduate Medical Center, Karachi from October 2021 to March 2022. The questionnaire was filled during an interview. First part included demographic profile, second part comprised of 5 items with 'yes' or 'no' options. Any positive answer meant woman was subjected to abuse. Adverse maternal outcome was also assessed. Out of a total of 105 pregnant women, 43(41%) women suffered domestic violence. Verbal or emotional violence (39%) was the most common type of violence. In our study, anemia (71.4%) was the most common complication. Preterm labor (63.8%) was the second on the list. was significantly associated with domestic violence (P-value<0.05). Educational status, employment status, substance abuse, and household monthly income of spouse had a significant association (P-value<0.05) with domestic violence. Our study shows that high frequency of violence at the time of pregnancy is related to negative maternal outcomes. Women should be screened for violence and support services for such women should be provided in the country.

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.

Obstetric violence in pregnancy and childbirth as a violation of women's human rights

Obstetric violence in pregnancy and childbirth as a violation of women's human rights

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.

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.

"Psychological Injuries Are Not Visible": Experiences and Perceptions of Midwives and Nurses about Domestic Violence during Pregnancy.

This study aimed to describe perceptions and experiences of nurses and midwives working in primary care about domestic violence (DV) in pregnancy. Data were collected by conducting in-depth face-to-face interviews with 10 midwives and 7 nurses working in seven family health centers between July 17 and August 28, 2020. Five main themes emerged: "The causes of domestic violence," "Difficulty recognizing domestic violence," "Obstacles to revealing domestic violence," "Obstacles to Assisting/Supporting domestic violence in pregnant women," and "Solutions to prevent domestic violence in pregnancy." Midwives/nurses feel inadequate and unprepared to recognize the symptoms of DV and to guide and support women and they are willing to take an active role in managing DV. It is recommended that they should be trained on DV, a monitoring system should be established including primary healthcare services and a measurement tool should be developed.

HIDDEN HURT – UNTOLD STORY OF A WOMB. A STUDY ON PREVELANCE OF DOMESTIC VIOLENCE IN PREGNANCY IN A RURAL MEDICAL COLLEGE, KARNATAKA.

Domestic violence is threatening behaviour, violence, or abuse between adults who are, or have been, intimate partners or family members. Such abuse may take various forms, including physical violence, sexual violence, emotionally abusive behaviours, economic restrictions, and other controlling behaviours. Domestic violence is a common worldwide phenomenon. We conducted this study with the aims 1. To know the prevalence of domestic violence in pregnancy. 2. To know the type of domestic violence in pregnancy. 3. To know the perpetrator of domestic violence in pregnancy. This is a cross-sectional, questionnaire based study conducted in the setting of a medical college and hospital predominantly catering the health needs of the rural population. Pregnant women attending antenatal clinic, who were willing to participate were included in the study. Condentiality and modesty of participants were maintained throughout the study. Data was collected from the participants in a private counseling room. Data thus obtained was analyzed using descriptive statistics. This study had 200 participants, Out of which 12 (6%) participants reported to have experienced violence. 10 (5%) participants experienced physical violence, 9 (4.5%) participants experiences psychological violence, 1 ( 0.5%) experienced sexual violence. 9 (4.5%) of our participants experienced violence from husband and 3 (1.5%) experience violence from mother in law. We concluded that domestic violence in pregnancy is still prevalent in the modern era. Any type of violence in pregnancy should alert clinician and stake holders to take necessary action in prevention of the same. Psychological counselling should be a part of antenatal care.

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.

Risk of interpersonal violence during and after pregnancy among people with schizophrenia: a population-based cohort study.

Schizophrenia is associated with increased risk of experiencing interpersonal violence. Little is known about risk specifically around the time of pregnancy. This population-based cohort study included all individuals (aged 15-49 yr) listed as female on their health cards who had a singleton birth in Ontario, Canada, between 2004 and 2018. We compared those with and without schizophrenia on their risk of an emergency department (ED) visit for interpersonal violence in pregnancy or within 1 year postpartum. We adjusted relative risks (RRs) for demographics, prepregnancy history of substance use disorder and history of interpersonal violence. In a subcohort analysis, we used linked clinical registry data to evaluate interpersonal violence screening and self-reported interpersonal violence during pregnancy. We included 1 802 645 pregnant people, 4470 of whom had a diagnosis of schizophrenia. Overall, 137 (3.1%) of those with schizophrenia had a perinatal ED visit for interpersonal violence, compared with 7598 (0.4%) of those without schizophrenia, for an RR of 6.88 (95% confidence interval [CI] 5.66-8.37) and an adjusted RR of 3.44 (95% CI 2.86-4.15). Results were similar when calculated separately for the pregnancy (adjusted RR 3.47, 95% CI 2.68-4.51) period and the first year postpartum (adjusted RR 3.45, 95% CI 2.75-4.33). Pregnant people with schizophrenia were equally likely to be screened for interpersonal violence (74.3% v. 73.8%; adjusted RR 0.99, 95% CI 0.95-1.04), but more likely to self-report it (10.2% v. 2.4%; adjusted RR 3.38, 95% CI 2.61-4.38), compared with those without schizophrenia. Among patients who did not self-report interpersonal violence, schizophrenia was associated with an increased risk for a perinatal ED visit for interpersonal violence (4.0% v. 0.4%; adjusted RR 6.28, 95% CI 3.94-10.00). Pregnancy and postpartum are periods of higher risk for interpersonal violence among people with schizophrenia compared with those without schizophrenia. Pregnancy is a key period for implementing violence prevention strategies in this population.

Prevalence and Risk Factors of Domestic Violence in Primigravidae in Low Socio-Economic Areas of Hamedan, Iran

Background and Objective: Domestic violence against women is a major physical and mental health problem all across the globe. Therefore, the present study aimed to investigate the prevalence of domestic violence in pregnancy, as well as its correlation with sociodemographic and psychological characteristics. Materials and Methods: This cross-sectional study was conducted on 360 pregnant women who were referred to the health care centers of Hamedan in 2022. Data were collected through a questionnaire that consisted of three parts: sociodemographic characteristics, psychological characteristics, and the questionnaire on domestic violence (Revised Conflict Tactics Scales OR CTS2). Data analysis was performed in SPSS software (version 20) using descriptive statistics, t-test, and Chi-square. Results: The overall Prevalence of domestic violence during pregnancy was 58.6%. The prevalence rates of emotional, sexual, and physical violence were obtained at 46.8%, 31.6%, and 27.7%, respectively. The level of education, occupation, wealth index, as well as alcohol and drug abuse, had a significant relationship with domestic violence (P&lt;0.001). Domestic violence was significantly correlated with unplanned pregnancies (P&lt;0.001), self-esteem (P&lt;0.004), stress (P&lt;0.001), social support (P&lt;0.001), and prenatal depression (P&lt;0.001). Conclusion: The results of this study pointed to a relatively high prevalence of domestic violence during pregnancy. Therefore, it is suggested that all prenatal care centers have a screening program to identify domestic violence. Moreover, it is recommended to educate health professionals and women at risk and implement support programs for injured women.

Physical violence in pregnancy: a cross-sectional study with women in puerperium attended in a public service of reference, São Paulo, Brazil

Introduction: Violence against women during pregnancy is recognized as a violation of human rights and reproductive rights, and a serious public health problem. Its prevalence is variable and has a multifactorial cause, requiring permanent monitoring. Method: Cross-sectional study conducted at the Hospital of Mandaqui, São Paulo, Brazil. The Abuse Assessment Screen (AAS) was applied to 350 puerperium women, with the outcome of suffering or not physical violence during pregnancy, between September and December 2021. Sociodemographic and reproductive data were considered. We used urn technique, with data were pre-coded, and EpiInfo® analysis by Pearson chi-square and Mann Whitney, adopting p&lt;0.05 and 95% CI value. Research approved by the Research Ethics Committee, CAAE no. 50580421.5.0000.5551. Results: We found 13 cases of physical violence (3.7%) and sample loss of 18.9%. Women with physical violence during pregnancy showed lower mean age (27.7±8.24 x 37.3±6.28); less work (15.4% x 45.1%. p=0.034, OR/CI 0.98:0.98-20.70); less income (84.6% x 51.1%. p=0.017, OR/CI 0.18:0.04-0.86); higher occurrence of prematurity (30.8% x 9.5%. p=0.001, OR/CI 0.18: 0.05-0.59); and higher tobacco/alcohol use (38.5% x 10.4%. p=0.013, OR/CI 0.23:0.06-0.80). We found higher reports of violence before the age of 15 (53.8% x 18.7%. p&lt;0.001, OR/CI 0.19: 0.06-0.60); physical violence in the last 12 months (84.6% x 1.8%. p&lt;0.001); with a history of physical or emotional violence by the partner (76.9% x 29.4%. p&lt;0.001, OR/CI 0.12:0.03-0.46); and fear of the intimate partner (46.2% x 2.4%. p&lt;0.001, OR/CI 0.02:0.00-0.10). There was no difference for low schooling, race/color, union, pregnancy planning and high-risk pregnancy. Conclusion: The prevalence of physical violence during pregnancy was lower than in other studies in Brazil and other countries. The results suggest that gender violence is present throughout the life of women who suffer physical violence during pregnancy, reflecting in unfavorable reproductive outcomes. The high history of violence and fear of the partner may have contributed to eventual understatement.