Maternal outcomes associated to psychological and physical intimate partner violence during pregnancy: A cohort study and multivariate analysis

• Published in: PloS one 2019-06, Vol.14 (6), p.e0218255-e0218255
• Main Authors: Martin-de-Las-Heras, Stella, Velasco, Casilda, Luna-Del-Castillo, Juan de Dios, Khan, Khalid S
• Format: Article
• Language: English
• Subjects: Abuse; Adult; Aggression; Childrens health; Cohort analysis; Cohort Studies; Complications; Confidence intervals; Confidentiality; Conjugal violence; Crimes against; Criminal investigations; Cross-Sectional Studies; Data collection; Demographics; Domestic violence; Emotional abuse; Female; Gestational diabetes; Health aspects; Hospitals; Humans; Infections; Intimate partner violence; Intimate Partner Violence - psychology; Logistic Models; Medicine and Health Sciences; Midwifery; Midwives; Mothers; Multivariate Analysis; Murders & murder attempts; Obstetricians; Obstetrics; Odds Ratio; Pregnancy; Pregnancy complications; Pregnancy Outcome - psychology; Pregnant women; Prenatal Care; Psychological aspects; Public health; Public hospitals; Regression analysis; Sample size; Sex crimes; Social Sciences; Sociodemographics; Spain; Spanish language; Spouse Abuse - psychology; Statistical analysis; Studies; Ultrasound; Urinary tract; Urinary tract infections; Vagina; Victimization; Violence; Womens health; Young Adult
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0218255

Intimate partner violence (IPV) is a public health problem that affects millions of women worldwide and can occur during both pregnancy and the perinatal period. We aimed to evaluate if the experience of psychological and physical intimate partner violence (IPV) adversely affects pregnancy outcomes. We established a cohort of 779 consecutive mothers receiving antenatal care including ultrasound and giving birth in 15 public hospitals, drawn using cluster sampling of all obstetric services in Andalusia, Spain (February-June 2010). Trained midwives gathered IPV data using the Index of Spouse Abuse validated in the Spanish language (score ranges: 0-100, higher scores reflect more severe IPV; cut-offs: physical IPV = 10, psychological IPV = 25). Socio-demographic data, including lack of kin support, maternal outcomes, and hospitalization were collected. Multivariate logistic regression estimated adjusted odds ratios (AOR), with 95% confidence intervals (CI), of the relationship between psychological and physical IPV and maternal outcomes, controlling for socio-demographic characteristics. Response rate was 92.2%. Psychological IPV, reported by 21.0% (n = 151), was associated significantly with urinary tract infection (127 (23%) vs 56 (37%); AOR = 1.9; 95%CI = 1.2-3.0), vaginal infection (30 (5%) vs 20 (13%); AOR = 2.4; 95%CI = 1.2-4.7) and spontaneous preterm labour (32 (6%) vs 19 (13%); AOR = 2.2; 95%CI = 1.1-4.5). Physical IPV, reported by 3.6% (n = 26), was associated with antenatal hospitalizations (134 (19%) vs 11 (42%); AOR = 2.6; 95%CI = 1.0-7.1). Lack of kin support was associated with spontaneous preterm labour (AOR = 4.7; 95%CI = 1.7-12.8). Mothers with IPV have higher odds of complications. Obstetricians, gynaecologists and midwives should act as active screeners, particularly of the undervalued psychological IPV, to reduce or remedy its effects.