Intimate partner violence during pregnancy and its association with preterm birth and low birth weight in Tanzania: A prospective cohort study

Abstract

IntroductionIntimate partner violence (IPV) is a public health problem that affects millions of women worldwide. The role of violence as an underlying factor in poor birth outcomes remains an area where strong evidence is lacking. The aim of this study was to determine the association between intimate partner violence (IPV) and preterm delivery (PTB) and low birth weight (LBW).Materials and methodsA prospective cohort study was conducted among 1112 pregnant women attending antenatal care in Moshi–Tanzania. The women were enrolled before 24 weeks gestation, followed-up at week 34 to determine exposure to violence during pregnancy, and after delivery to estimate gestation age at delivery and birth weight. Logistic regression analysis was performed to assess the association between exposure to IPV during pregnancy and PTB and LBW while adjusting for possible confounders. In addition, stratified analysis based on previous history of adverse pregnancy outcome was performed.ResultsOne-third of the women experienced IPV during pregnancy, 22.3% reported emotional, 15.4% sexual and 6.3% physical violence. Women exposed to physical IPV were three times more likely to experience PTB (AOR = 2.9; CI 95%: 1.3–6.5) and LBW (AOR = 3.2; CI 95%: 1.3–7.7). Women with previous adverse pregnancy outcomes and exposure to physical IPV had a further increased risk of PTB (AOR = 4.5; CI 95%: 1.5–13.7) and LBW (AOR = 4.8; CI 95%: 1.6–14.8) compared to those without previous history of adverse outcome.ConclusionWomen who are exposed to IPV during pregnancy are at increased risk of PTB and LBW. The risk is even stronger if the women additionally have suffered a previous adverse pregnancy outcome. Interventions addressing IPV are urgently needed to prevent occurrence and reoccurrence of PTB and LBW.

Effectiveness of a counselling intervention implemented in antenatal setting for pregnant women facing domestic violence: a pre‐experimental study

“…This finding is in line with existing evidence in the literature that women are more likely to disclose violence to a healthcare provider. 45 A study evaluating the similar intervention through a randomised control trial also showed improvement in the health status of women 22 but another study in Peru found no statistically significant impact on health-related quality of life. 40, 41 The effect of violence on physical and mental health of women found in the study has been well documented in other literature.…”

“…A study in an ANC setting has also found the crucial role of social support in mitigating the consequences of IPVDP. 45 A study evaluating the similar intervention through a randomised control trial also showed improvement in the health status of women 22 but another study in Peru found no statistically significant impact on health-related quality of life. 23 This study suggests that the number of counselling sessions required to have an impact can vary from woman to woman.…”

Determinants of preterm birth among mothers who gave birth in East Africa: systematic review and meta-analysis

“…The effects of IPV on PTB were examined by three studies. Of three, two studies found positive association between IPV and PTB [35,53] and one found no association [58]. Women exposed to IPV (AOR 2.5; 95% CI: 2.19-2.96) and physical violence (AOR 5.3; 95% CI: 3.95-7.09) during pregnancy were more likely to experience PTB [53].…”

“…The studies were included from 11 East African countries. Nineteen studies were from Tanzania [33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51]…”

Intimate Partner Violence: A Potential Challenge for Women’s Health in Angola

“…Regardless of these evidence, IPV continues to be a serious challenge for the promotion of women's health especially in the sub-Saharan African countries. Given women's predominant role in childcare, the effects of IPV can extend well beyond women's own health and are associated with poor anthropometric and neurodevelopmental issues among infants and toddlers [3,5,21]. Based on these well-documented findings, it is assumable that IPV is also contributing to the high maternal and child mortality rates, which can hinder the progress to several Sustainable Development Goals relevant to women's health (SDG 3), gender-equality (SDG 5) and peace and justice (SDG 10).…”