Intimate partner violence and severe acute maternal morbidity in the intensive care unit: A case‐control study in Peru

Abstract

Background Intimate partner violence is a prevalent public health issue associated with all‐cause maternal mortality. This study investigated the relationship between intimate partner violence, severe acute maternal morbidity in the intensive care unit (ICU), and neonatal outcomes. Methods This was a prospective case‐control study in a hospital in Lima, Peru, with 109 cases (maternal ICU admissions) and 109 controls (obstetric patients not admitted to the ICU). Data were collected through face‐to‐face interviews and medical record review. Partner violence was assessed using the World Health Organization instrument. Multivariate logistic regression was used to model the association between intimate partner violence and severe acute maternal morbidity. Results There was a significantly higher rate of intimate partner violence both before and during pregnancy among cases (58.7%) than controls (27.5%). In multivariate analysis, intimate partner violence both before and during pregnancy (aOR 3.83 (95% CI: 1.99‐7.37)), being married (3.86 (1.27‐11.73)), having <8 antenatal care visits (2.78 (1.14‐6.80)), and having previous abortions (miscarriage, therapeutic, or unsafe) (1.69 (1.13‐2.51)) were significantly associated with severe acute maternal morbidity. The ICU admission rate was 18.8 (per 1000 live births), and ICU maternal mortality was 1.7%. The perinatal mortality rate was higher in cases (9.3%) than in controls (1.8%). Conclusions Intimate partner violence was associated with an increased risk of severe acute maternal morbidity. This suggests a more severe impact of intimate partner violence on pregnancy than has been previously identified. Inquiring about intimate partner violence during prenatal visits may prevent further harm to the mother‐baby dyad.

Violência Por Parceiro Íntimo Na Gestação E Repercussão Na Saúde Da Mulher E Do Concepto

“…Os achados deste estudo reforçam a evidência de que as mulheres que sofrem VPI antes da gravidez são significativamente mais propensas a ter Intervalo curto entre partos curta em comparação com as mulheres que não sofreram VPI antes da gravidez. A10 (30) Investigar a relação entre VPI e morbidade materna aguda grave em unidade de terapia intensiva (UTI) e desfechos neonatais.…”

Epidemiologia da morte materna e o desafio da qualificação da assistência

“…(13) Quanto a situação conjugal, pesquisadores concordam que a presença do companheiro tem sido interpretada como possibilidade de maior suporte emocional durante a gravidez e parto. (14) Outro aspecto identificado no presente estudo foi o acesso garantido das gestantes ao pré-natal, seja através da atenção primária ou pela saúde suplementar, a maioria das mulheres teve acesso ao acompanhamento pré-natal iniciando ainda no primeiro trimestre, perfazendo seis ou mais consultas, conforme preconizado pelas diretrizes da Rede Cegonha, porém com desfecho desfavorável. Tal fato chama atenção de que mesmo garantindo os indicadores do Ministério da Saúde, como captação precoce, número de consultas e acesso, que são indicadores quantitativos, a qualidade não é mensurada por esses dados na atenção obstétrica.…”

MOSAIC (MOthers’ AdvocateS In the Community) for Pregnant Women and Mothers of Children Under 5 with Experience of Intimate Partner Violence: A pilot randomized trial study protocol

“…They are more likely than women without IPV to miss three or more prenatal visits (15). Perinatal women with experience of IPV are twice as likely to have babies with low birthweight (16), higher rates of severe acute maternal morbidity (17) and have infants requiring intensive care (18). IPV increases risk of depressive and PTSD symptoms, which in turn increases risk of subsequent IPV (19)(20)(21) (8,21).…”