Journal of South Asian Federation of Obstetrics and Gynaecology

Register      Login

VOLUME 10 , ISSUE 2 ( April-June, 2018 ) > List of Articles

PROSPECTIVE OBSERVATIONAL STUDY

Effects of Intimate Partner Violence on Pregnancy Outcome

S Shantha Kumari, Kiranmai Devineni, Nagamani Sodumu

Keywords : Domestic violence, Intimate partner violence, Pregnancy outcome

Citation Information : Kumari SS, Devineni K, Sodumu N. Effects of Intimate Partner Violence on Pregnancy Outcome. J South Asian Feder Obs Gynae 2018; 10 (2):142-148.

DOI: 10.5005/jp-journals-10006-1578

Published Online: 01-06-2018

Copyright Statement:  Copyright © 2018; The Author(s).


Abstract

Introduction: Intimate partner violence (IPV) is a significant, yet preventable public health problem that affects millions of women regardless of age, economic status, race, religion, ethnicity, sexual orientation, or educational background. The IPV has been associated with poor pregnancy outcomes, such as anemia, still birth, abruption, fetal injury, preterm delivery, and low birth weight. With this background, we did a screening study to assess prevalence, demographic features, and maternal and neonatal outcomes. Materials and methods: This is a prospective observational study done at the Modern Government Maternity Hospital, Osmania Medical College, Hyderabad, India. About 300 pregnant women admitted for various obstetric reasons during January 2013 and December 2013 and delivered were considered for the study. History and various aspects of domestic violence were obtained with a detailed written pro forma. Descriptive analysis was carried out to summarize relevant variables. Primary outcomes included incidence, risk factors, maternal morbidity, and fetal and neonatal outcome. Results: About 114 women (38%) revealed domestic violence, which is very high compared with 0.8% when there was no screening for domestic violence. A total of 186 women showed no history of violence. Demographic features and obstetric outcomes were compared. About 90% women in both groups were economically dependent. About 50% women did not have a right over their reproductive choices. About 33 women faced violence at the time of pregnancy (28.9%). Very strong association between antenatal care booking and partner abuse was observed. About 50% had less than three visits and 64.4% of abusive partners are alcoholic. Gender bias, male child preference, unemployment, and dowry were the other common causes for abuse. Abruption was seen in 6.14% in the abuse group vs 1.79% in the control group. Preterm labor was 6.14 vs 2.15%. Four women with severe acute maternal morbidity due to IPV and one case of severe sexual violence have been highlighted. Conclusion: Domestic violence and IPV are widely prevalent, and what is visible is only the tip of the iceberg. It contributes to a spectrum of maternal and fetal complications. The obstetrician–gynecologist has the unique opportunity to screen for domestic violence, and screening for domestic violence has to be made part of antenatal care. Linking up medical, legal, police, welfare homes, and counseling can go a long way. Millennium development goal (MDG) 3, i.e., gender parity, should be the route to achieve MDG 4 and 5.


PDF Share
  1. Granja AC, Zacarias E, Bergström S. Violent deaths: the hidden face of maternal mortality. BJOG 2002 Jan;109(1):5-8.
  2. Garcia-Moreno C, Jansen HA, Ellsberg M, Heise L, Watts CH; WHO Multi-country Study on Women's Health and Domestic Violence against Women Study Team. Prevalence of intimate partner violence: findings from the WHO multi-country study on women's health and domestic violence. Lancet 2006 Oct;368(9543):1260-1269.
  3. National Family Health Survey 2015-2016 (NFHS-4): India fact sheets. Mumbai: IIPS; 2016. [cited 2017 Mar 1]. Available from: rchiips.org/NFHS/factsheet_NFHS-4.shtml#.
  4. Statistics Canada. The daily (Cat. No. 11-001E). Ottawa: Statistics Canada; 1993.
  5. Reid AJ, Biringer A, Carroll JD, Midmer D, Wilson LM, Chalmers B, Stewart DE. Using the ALPHA form in practice to assess antenatal psychosocial health. Antenatal Psychosocial Health Assessment. CMAJ 1998 Sep;159(6):677-684.
  6. Zareen N, Majid N, Naqvi S, Saboohi S, Fatima H. Effect of domestic violence on pregnancy outcome. J Coll Physicians Surg Pak 2009 May;19(5):291-296.
  7. Widding, H.; Janson, P. Abuse of women during pregnancy. Sweden: Gothenburg University; 1999.
  8. Urquia ML, O'Campo PJ, Heaman MI, Janssen PA, Thiessen KR. Experiences of violence before and during pregnancy and adverse pregnancy outcomes: an analysis of the Canadian Maternity Experiences Survey. BMC Pregnancy Childbirth 2011 Jun;11:42.
  9. Taillieu TL, Brownridge DA. Violence against pregnant women: prevalence, patterns, risk factors, theories, and directions for future research. Aggress Violent Behav 2010 Jan-Feb;15(1):14-35.
  10. Luo ZC, Wilkins R, Kramer MS; Fetal and Infant Health Study Group of the Canadian Perinatal Surveillance System. Disparities in pregnancy outcomes according to marital and cohabitation status. Obstet Gynecol 2004 Jun;103(6): 1300-1307.
  11. Kramer MS, Séguin L, Lydon J, Goulet L. Socio-economic disparities in pregnancy outcome: why do the poor fare so poorly? Paediatr Perinat Epidemiol 2000 Jul;14(3): 194-210.
  12. Ganatra BR, Coyaji KJ, Rao VN. Too far, too little, too late: a community-based case-control study of maternal mortality in rural west Maharashtra, India. Bull World Health Organ 1998;76(6):591-598.
  13. Corsi PR, Rasslan S, de Oliveira LB, Kronfly FS, Marinho VP. Trauma in pregnant women: analysis of maternal and fetal mortality. Injury 1999 May;30(4):239-243.
  14. Campbell JC. Health consequences of intimate partner violence. Lancet 2002 Apr;359(9314):1331-1336.
  15. Kearney MH, Munro BH, Kelly U, Hawkins JW. Health behaviors as mediators for the effect of partner abuse on infant birth weight. Nurs Res 2004 Jan-Feb;53(1):36-45.
  16. Hall M, Chappell LC, Parnell BL, Seed PT, Bewley S. Associations between intimate partner violence and termination of pregnancy: a systematic review and meta-analysis. PLoS Med 2014 Jan;11(1):e1001581.
  17. Altarac M, Strobino D. Abuse during pregnancy and stress because of abuse during pregnancy and birthweight. J Am Med Womens Assoc (1972) 2002 Fall;57(4):208-214.
  18. Audi CA, Correa AM, Latorre Mdo R, Santiago SM. The association between domestic violence during pregnancy and low birth weight or prematurity. J Pediatr (Rio J) 2008 Jan-Feb;84(1):60-67.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.