Birth outcomes in a Swedish population of women reporting a history of violence including domestic violence during pregnancy: A longitudinal cohort study

Abstract

Background: Victimisation of women is encountered in all countries across the world, it damages the mental and physical health of women. During pregnancy and the postpartum period, women are at a greater risk of experiencing violence from an intimate partner. The aim of this study was to explore childbirth outcomes in a Swedish population of women reporting a history of violence including domestic violence during pregnancy. Methods: A longitudinal cohort design was utilised. In total 1939 pregnant women ≥ 18 years were recruited to answer two questionnaires, during early and late pregnancy. The available dataset included birth records of 1694 mothers who gave birth between June 2012 and April 2014. Statistical analyses included descriptive statistics, T-test and bivariate logistic regression. Results: Of 1694 mothers 38.7 % (n = 656) reported a history of violence and 2% (n = 34) also experienced domestic violence during pregnancy. Women who were single, living apart from their partner, were unemployed, had financial distress and were smokers were at a higher risk of experiencing violence (p = 0.001). They also had significant low scores on the SOC-scale and high EDS-scores ≥ 13 (p =0.001) when compared to women without a history of violence (p = 0.001). Having a history of violence increased a woman’s risk of having caesarean section (OR 1.33, 95 % CI 1.02 -1.70). Likewise, a history of emotional abuse, significantly increased the risk of having a caesarean section irrespective of whether it was planned or an emergency caesarean section (OR 1.50, 95% CI 1.09-2.06). Infants born to a mother who reported a history of violence, were at significant risk of being born premature < 37 weeks of gestation compared to infants born by mothers with no history of violence (p = 0,049). Conclusions: A history of violence and exclusively a history of emotional abuse has a negative impact on childbirth outcomes including caesarean section and premature birth. Therefore, early identification of a history of or ongoing violence is crucial to provide women with extra support which may have positive impact on birth outcome.

Maltrato en la gestante adolescente y su efecto en el peso del recién nacido en la altura geográfica peruana, Huancayo, Perú

“…Asimismo, se ha reportado que las gestantes adolescentes comprometidas tempranamente son las más dependientes de sus parejas, lo que las hace más vulnerables a los abusos 7 . No obstante, se sabe que estos porcentajes pueden variar según cada realidad; por ejemplo, estudios realizados en Etiopía y Suecia reportaron que la prevalencia de violencia en gestantes fue del 31% y el 2%, respectivamente, pero ambos destacan el hecho de que cuanto más jóvenes eran las gestantes más grave era el maltrato 17,18 . La variación entre nuestros resultados y los de otros estudios podría atribuirse a las distintas medidas para evaluar la exposición a la violencia y a las diferencias étnicas y socioeconómicas de todas las poblaciones.…”

“…Este resultado ha sido previamente reportado por un metaanálisis que encontró que las mujeres que experimentan violencia durante el embarazo (por parte de su pareja íntima) tienen un mayor riesgo de tener un resultado adverso en el parto, en comparación con las mujeres que no experimentan esta situación, lo que obliga a tener ingresos repetitivos al hospital 22 . Del mismo modo, otro estudio reportó que las gestantes que experimentaron violencia doméstica durante el embarazo tuvieron un alto riesgo de tener un parto por cesárea planificada o por emergencia (OR: 1,50; IC95%: 1,09-2,06) 17 .…”

Sense of coherence in pregnancy: a systematic review of the literature.

“…Spontaneous labor (as opposed to induction and a vaginal birth) was less prevalent in the "emotionally unhealthy" group while there was a higher prevalence in the "emotionally unhealthy" group in the use of epidural analgesia or augmentation of labor and babies born to have a severe neonatal diagnosis. [34,35,37,39,46,53,56,73] did not report EPDS scores while seven studies [35,37,39,44,56,70,73] did not provide measures of SOC. Not surprisingly, none of the seven studies [35,37,39,44,56,70,73] reported relationship between EPDS and SOC measures.…”

Self‐efficacy and social support as mediators of mental health among abused women

“…1 This definition is consistent with the description provided by the World Health Organization [WHO] (2013). Existing literature well documents the adverse impact of DFV during and around pregnancy on mental health and well‐being of victims (Finnbogadóttir et al, 2020; Tavoli et al, 2016). As a result, interventions aiming to improve psychosocial outcomes of DFV victims have been increasing, albeit with continuing methodological limitations and mixed findings (Daley et al, 2020; Sapkota et al, 2019a).…”