Development of the Intimate Partner Violence During Pregnancy Instrument (IPVPI)

Abstract

Background: Intimate partner violence (IPV) during pregnancy can lead to negative consequences for both the mother and offspring. Although IPV is recognized as a worldwide public health issue, its prevalence is considered to be underestimated because cases are likely underreported, suggesting that there might be unmeasured IPV. The aim of this study was to develop an instrument to detect IPV in pregnant women. Methods: A total of 6,590 women in Aichi prefecture, Japan, who took part in a 3 or 4 month infant health checkup program, participated in the study. Questionnaires assessing history of IPV during pregnancy (physical abuse and verbal abuse), maternal characteristics, partner's characteristics, and household characteristics were mailed to women before, or distributed at, the checkup. Women returned the questionnaires to the checkup sites or mailed them back to the health centers. A prediction model for history of IPV was then generated using potential risk factors selected based on the literature. Results: Among 6,530 women who responded to either question on IPV during pregnancy (response rate = 67.3%), the rate of participants who experienced any IPV during pregnancy was 11.1% (physical IPV = 1.2%; verbal IPV = 10.8%). Multiple logistic regression analyses showed that maternal age (<25 years old), multiparity, history of artificial abortion, negative feelings when the pregnancy was confirmed (e.g., confused), having no one to provide support during pregnancy, having relationship problems with their partner, paternal smoking during pregnancy, and difficult financial status were associated with any abuse from the partner. Based on the analysis, the Intimate Partner Violence during Pregnancy Instrument (IPVPI) was developed, comprising of eight questions to detect unmeasured IPV in pregnant women, and showed moderate predictive power (area under receiver operating characteristic curve = 0.719, 95% confidence interval: 0.698 to 0.740) ranging from 0 to 16 with a cut-off point of 2 (sensitivity = 79.5%, specificity = 47.1%). Conclusion: The IPVPI, which allows to ask indirect questions rather that asking directly about experience of IPV, might be helpful to detect unmeasured IPV in pregnant women in fields of primary healthcare and obstetrics. Further research longitudinal studies are needed to improve the sensitivity and specificity of the IPVPI.

Does intimate partner violence influence the utilization of maternal health services?

“…In the same way, higher education has been associated with lower levels of IPV which supports the findings in this study (29). Previous research also supports that younger age and poorer financial status were associated with IPV during pregnancy as observed by Doi et al (2019). Another study showed that poverty, lack of education and food security is associated with IPV during and after pregnancy (30,31).…”

“…Dramatic evidence shows that nearly one third of women aged 15 years and older have experienced IPV during their lifetime globally, and nearly two-thirds of the women in East Asia have experienced IPV (10). IPV during pregnancy leads to negative consequences not only for the mother but also affects children, general women's health, and the economy (11). It is claimed that the cost of IPV is five percent of the total gross domestic product [GDP] (12).…”

Does intimate partner violence influence the utilization of maternal health services?

“…In the same way, higher education leads to lower IPV which supports the study (28). The study also supports that younger age and poor financial status were associated with IPV during pregnancy as observed by Doi et al (2019). Another study shows that poverty, lack of education and food security lead to IPV during and after pregnancy (29,30).…”

“…IPV during pregnancy leads negative consequences not only the mother but also affects the offspring women's health, and economy (11). It is claimed that the cost of IPV is five percent of the total gross domestic product [GDP] (12).…”

Preventing postpartum depressive symptoms using an educational video on infant crying: A cluster randomized controlled trial

“…Our hypothesis was that younger mothers may have much more room to improve crying knowledge through educational intervention, which results in lower prevalence of PDD. In this study, young mothers were defined as mothers aged <25 years rather than limited to teenagers due to the Japanese context (Doi & Fujiwara, 2019; Doi, Fujiwara, & Isumi, 2019), that is, maternal age is increasing (the average maternal age at first birth was 25.7‐years old in 1975 and 30.7‐years old in 2015 [Ministry of Health, Labor, and Welfare, 2019]). Among 918,397 births in 2018, teen mothers were only 0.95% whereas mothers aged 24 or less were 9.3% (Ministry of Health, Labor, and Welfare, 2019).…”