Social determinants and exposure to intimate partner violence in women with severe acute maternal morbidity in the intensive care unit: a systematic review

• Published in: BMC pregnancy and childbirth 2023-09, Vol.23 (1), p.1-13, Article 656
• Main Authors: Ayala Quintanilla, Beatriz Paulina, Taft, Angela, McDonald, Susan, Pollock, Wendy, Roque Henriquez, Joel Christian
• Format: Article
• Language: English
• Subjects: Age; Domestic violence; Ethnicity; High income; Industrialized nations; Intensive care; Intensive care units; Intimate partner violence; Low income groups; Maternal child nursing; Maternal mortality; Morbidity; Obstetrics; Pregnancy; Social determinants of health; Systematic review; Trauma; Womens health
• ISSN: 1471-2393; 1471-2393
• DOI: 10.1186/s12884-023-05927-5

BackgroundStudying severe acute maternal morbidity in the intensive care unit improves our understanding of potential factors affecting maternal health.AimTo review evidence on maternal exposure to intimate partner violence and social determinants of health in women with severe acute maternal morbidity in the intensive care unit.MethodsThe protocol for this review was registered in PROSPERO (registration number CRD42016037492). A systematic search was performed in MEDLINE, CINAHL, ProQuest, LILACS and SciELO using the search terms “intensive care unit”, “intensive care”, “critical care” and “critically ill” in combination with “intimate partner violence”, “social determinants of health”, “severe acute maternal morbidity”, pregnancy, postpartum and other similar terms. Eligible studies were (i) quantitative, (ii) published in English and Spanish, (iii) from 2000 to 2021, (iv) with data related to intimate partner violence and/or social determinants of health, and (v) investigating severe acute maternal morbidity (maternity patients treated in the intensive care unit during pregnancy, childbirth or within 42 days of pregnancy termination). Of 52,866 studies initially identified, 1087 full texts were assessed and 156 studies included. Studies were independently assessed by two reviewers for screening, revision, quality assessment and abstracted data. Studies were categorised into high/middle/low-income countries and summarised data were presented using a narrative description, due to heterogenic data as: (i) exposure to intimate partner violence and (ii) social determinants of health.ResultsOne study assessed intimate partner violence among mothers with severe acute maternal morbidity in the intensive care unit and found that women exposed to intimate partner violence before and during pregnancy had a nearly four-fold risk of severe acute maternal morbidity requiring ICU admission. Few social determinants of health other than age were reported in most studies.ConclusionThis review identified a significant gap in knowledge concerning intimate partner violence and social determinants of health in women with severe acute maternal morbidity in the intensive care unit, which is essential to better understand the complete picture of the maternal morbidity spectrum and reduce maternal mortality.