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Intimate partner violence, forced first sex and adverse pregnancy outcomes in a sample of Zimbabwean women accessing maternal and child health care.
BMC Public Health. 2018 05 03; 18(1):595.BP

Abstract

BACKGROUND

Intimate partner violence (IPV) remains a serious problem with a wide range of health consequences including poor maternal and newborn health outcomes. We assessed the relationship between IPV, forced first sex (FFS) and maternal and newborn health outcomes.

METHODS

A cross sectional study was conducted with 2042 women aged 15-49 years attending postnatal care at six clinics in Harare, Zimbabwe, 2011. Women were interviewed on IPV while maternal and newborn health data were abstracted from clinic records. We conducted logistic regression models to assess the relationship between forced first sex (FFS), IPV (lifetime, in the last 12 months and during pregnancy) and maternal and newborn health outcomes.

RESULTS

Of the recent pregnancies 27.6% were not planned, 50.9% booked (registered for antenatal care) late and 5.6% never booked. A history of miscarriage was reported by 11.5%, and newborn death by 9.4% of the 2042 women while 8.6% of recent livebirths were low birth weight (LBW) babies. High prevalence of emotional (63,9%, 40.3%, 43.8%), physical (37.3%, 21.3%, 15.8%) and sexual (51.7%, 35.6%, 38.8%) IPV ever, 12 months before and during pregnancy were reported respectively. 15.7% reported forced first sex (FFS). Each form of lifetime IPV (emotional, physical, sexual, physical/sexual) was associated with a history of miscarrying (aOR ranges: 1.26-1.38), newborn death (aOR ranges: 1.13-2.05), and any negative maternal and newborn health outcome in their lifetime (aOR ranges: 1.32-1.55). FFS was associated with a history of a negative outcome (newborn death, miscarriage, stillbirth) (aOR1.45 95%CI: 1.06-1.98). IPV in the last 12 months before pregnancy was associated with unplanned pregnancy (aOR ranges 1.31-2.02) and booking late for antenatal care. Sexual IPV (aOR 2.09 CI1.31-3.34) and sexual/physical IPV (aOR2.13, 95%CI: 1.32-3.42) were associated with never booking for antenatal care. Only emotional IPV during pregnancy was associated with low birth weight (aOR1.78 95%CI1.26-2.52) in the recent pregnancy and any recent pregnancy negative outcomes including LBW, premature baby, emergency caesarean section (aOR1.38,95%CI:1.03-1.83).

CONCLUSIONS

Forced first sex (FFS) and intimate partner violence (IPV) are associated with adverse maternal and newborn health outcomes. Strengthening primary and secondary violence prevention is required to improve pregnancy-related outcomes.

Authors+Show Affiliations

Foundation for Professional Development, 173 Mary Road, The Willows, Pretoria, 0184, South Africa. shamuts@yahoo.com. School of Public Health, University of the Witwatersrand, Johannesburg, South Africa. shamuts@yahoo.com.Department of Obstetrics and Gynaecology, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe.University of Montreal Hospital Research Centre, Montreal, QC, Canada. School of Public Health, University of the Western Cape, Bellville, 7535, South Africa.Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg, South Africa.International Centre for Reproductive Health, Ghent University, 9000, Ghent, Belgium.School of Public Health, University of the Western Cape, Bellville, 7535, South Africa. Gender and Health Research Unit, Medical Research Council, Cape Town, South Africa.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29724216

Citation

Shamu, Simukai, et al. "Intimate Partner Violence, Forced First Sex and Adverse Pregnancy Outcomes in a Sample of Zimbabwean Women Accessing Maternal and Child Health Care." BMC Public Health, vol. 18, no. 1, 2018, p. 595.
Shamu S, Munjanja S, Zarowsky C, et al. Intimate partner violence, forced first sex and adverse pregnancy outcomes in a sample of Zimbabwean women accessing maternal and child health care. BMC Public Health. 2018;18(1):595.
Shamu, S., Munjanja, S., Zarowsky, C., Shamu, P., Temmerman, M., & Abrahams, N. (2018). Intimate partner violence, forced first sex and adverse pregnancy outcomes in a sample of Zimbabwean women accessing maternal and child health care. BMC Public Health, 18(1), 595. https://doi.org/10.1186/s12889-018-5464-z
Shamu S, et al. Intimate Partner Violence, Forced First Sex and Adverse Pregnancy Outcomes in a Sample of Zimbabwean Women Accessing Maternal and Child Health Care. BMC Public Health. 2018 05 3;18(1):595. PubMed PMID: 29724216.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intimate partner violence, forced first sex and adverse pregnancy outcomes in a sample of Zimbabwean women accessing maternal and child health care. AU - Shamu,Simukai, AU - Munjanja,Stephen, AU - Zarowsky,Christina, AU - Shamu,Patience, AU - Temmerman,Marleen, AU - Abrahams,Naeemah, Y1 - 2018/05/03/ PY - 2017/04/24/received PY - 2018/04/16/accepted PY - 2018/5/5/entrez PY - 2018/5/5/pubmed PY - 2019/4/6/medline KW - Forced first sex KW - Intimate partner violence KW - Maternal and newborn health outcomes KW - Zimbabwe SP - 595 EP - 595 JF - BMC public health JO - BMC Public Health VL - 18 IS - 1 N2 - BACKGROUND: Intimate partner violence (IPV) remains a serious problem with a wide range of health consequences including poor maternal and newborn health outcomes. We assessed the relationship between IPV, forced first sex (FFS) and maternal and newborn health outcomes. METHODS: A cross sectional study was conducted with 2042 women aged 15-49 years attending postnatal care at six clinics in Harare, Zimbabwe, 2011. Women were interviewed on IPV while maternal and newborn health data were abstracted from clinic records. We conducted logistic regression models to assess the relationship between forced first sex (FFS), IPV (lifetime, in the last 12 months and during pregnancy) and maternal and newborn health outcomes. RESULTS: Of the recent pregnancies 27.6% were not planned, 50.9% booked (registered for antenatal care) late and 5.6% never booked. A history of miscarriage was reported by 11.5%, and newborn death by 9.4% of the 2042 women while 8.6% of recent livebirths were low birth weight (LBW) babies. High prevalence of emotional (63,9%, 40.3%, 43.8%), physical (37.3%, 21.3%, 15.8%) and sexual (51.7%, 35.6%, 38.8%) IPV ever, 12 months before and during pregnancy were reported respectively. 15.7% reported forced first sex (FFS). Each form of lifetime IPV (emotional, physical, sexual, physical/sexual) was associated with a history of miscarrying (aOR ranges: 1.26-1.38), newborn death (aOR ranges: 1.13-2.05), and any negative maternal and newborn health outcome in their lifetime (aOR ranges: 1.32-1.55). FFS was associated with a history of a negative outcome (newborn death, miscarriage, stillbirth) (aOR1.45 95%CI: 1.06-1.98). IPV in the last 12 months before pregnancy was associated with unplanned pregnancy (aOR ranges 1.31-2.02) and booking late for antenatal care. Sexual IPV (aOR 2.09 CI1.31-3.34) and sexual/physical IPV (aOR2.13, 95%CI: 1.32-3.42) were associated with never booking for antenatal care. Only emotional IPV during pregnancy was associated with low birth weight (aOR1.78 95%CI1.26-2.52) in the recent pregnancy and any recent pregnancy negative outcomes including LBW, premature baby, emergency caesarean section (aOR1.38,95%CI:1.03-1.83). CONCLUSIONS: Forced first sex (FFS) and intimate partner violence (IPV) are associated with adverse maternal and newborn health outcomes. Strengthening primary and secondary violence prevention is required to improve pregnancy-related outcomes. SN - 1471-2458 UR - https://www.unboundmedicine.com/medline/citation/29724216/Intimate_partner_violence_forced_first_sex_and_adverse_pregnancy_outcomes_in_a_sample_of_Zimbabwean_women_accessing_maternal_and_child_health_care_ L2 - https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-018-5464-z DB - PRIME DP - Unbound Medicine ER -