Dataset Information

Obstetric Outcomes of Mothers Previously Exposed to Sexual Violence.

ABSTRACT:

Background

There is a scarcity of data on the association of sexual violence and women's subsequent obstetric outcomes. Our aim was to investigate whether women exposed to sexual violence as teenagers (12-19 years of age) or adults present with different obstetric outcomes than women with no record of such violence.

Methods

We linked detailed prospectively collected information on women attending a Rape Trauma Service (RTS) to the Icelandic Medical Birth Registry (IBR). Women who attended the RTS in 1993-2010 and delivered (on average 5.8 years later) at least one singleton infant in Iceland through 2012 formed our exposed cohort (n = 1068). For each exposed woman's delivery, nine deliveries by women with no RTS attendance were randomly selected from the IBR (n = 9126) matched on age, parity, and year and season of delivery. Information on smoking and Body mass index (BMI) was available for a sub-sample (n = 792 exposed and n = 1416 non-exposed women). Poisson regression models were used to estimate Relative Risks (RR) with 95% confidence intervals (CI).

Results

Compared with non-exposed women, exposed women presented with increased risks of maternal distress during labor and delivery (RR 1.68, 95% CI 1.01-2.79), prolonged first stage of labor (RR 1.40, 95% CI 1.03-1.88), antepartum bleeding (RR 1.95, 95% CI 1.22-3.07) and emergency instrumental delivery (RR 1.16, 95% CI 1.00-1.34). Slightly higher risks were seen for women assaulted as teenagers. Overall, we did not observe differences between the groups regarding the risk of elective cesarean section (RR 0.86, 95% CI 0.61-1.21), except for a reduced risk among those assaulted as teenagers (RR 0.56, 95% CI 0.34-0.93). Adjusting for maternal smoking and BMI in a sub-sample did not substantially affect point estimates.

Conclusion

Our prospective data suggest that women with a history of sexual assault, particularly as teenagers, are at increased risks of some adverse obstetric outcomes.

SUBMITTER: Gisladottir A

PROVIDER: S-EPMC4805168 | biostudies-literature | 2016

REPOSITORIES: biostudies-literature

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Publications

Obstetric Outcomes of Mothers Previously Exposed to Sexual Violence.

Gisladottir Agnes A Luque-Fernandez Miguel Angel MA Harlow Bernard L BL Gudmundsdottir Berglind B Jonsdottir Eyrun E Bjarnadottir Ragnheidur I RI Hauksdottir Arna A Aspelund Thor T Cnattingius Sven S Valdimarsdottir Unnur A UA

PloS one 20160323 3

<h4>Background</h4>There is a scarcity of data on the association of sexual violence and women's subsequent obstetric outcomes. Our aim was to investigate whether women exposed to sexual violence as teenagers (12-19 years of age) or adults present with different obstetric outcomes than women with no record of such violence.<h4>Methods</h4>We linked detailed prospectively collected information on women attending a Rape Trauma Service (RTS) to the Icelandic Medical Birth Registry (IBR). Women who ...[more]

PMID: 27007230

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Project description:This study aims to report the epidemiology of sexual violence (SV) perpetration for both female and male youth across a broad age spectrum. Additionally, the etiology of SV perpetration is examined by identifying prior exposures that predict a first SV perpetration. Six waves of data were collected nationally online, between 2006 and 2012, from 1586 youth between 10 and 21 years of age. Five types of SV were assessed: sexual harassment, sexual assault, coercive sex, attempted rape, and rape. To identify how prior exposures may predict the emergence of SV in adolescence, parsimonious lagged multivariable logistic regression models estimated the odds of first perpetrating each of the five types of SV within the context of other variables (e.g., rape attitudes). Average age at first perpetration was between 15 and 16 years of age, depending on SV type. Several characteristics were more commonly reported by perpetrators than non-perpetrators (e.g., alcohol use, other types of SV perpetration and victimization). After adjusting for potentially influential characteristics, prior exposure to parental spousal abuse and current exposure to violent pornography were each strongly associated with the emergence of SV perpetration-attempted rape being the exception for violent pornography. Current aggressive behavior was also significantly implicated in all types of first SV perpetration except rape. Previous victimization of sexual harassment and current victimization of psychological abuse in relationships were additionally predictive of one's first SV perpetration, albeit in various patterns. In this national longitudinal study of different types of SV perpetration among adolescent men and women, findings suggest several malleable factors that need to be targeted, especially scripts of inter-personal violence that are being modeled by abusive parents in youths' homes and also reinforced by violent pornography. The predictive value of victimization for a subsequent first SV perpetration highlights the inter-relatedness of different types of violence involvement. Universal and holistic prevention programming that targets aggressive behaviors and violent scripts in inter-personal relationships is needed well before the age of 15 years.

Project description:BackgroundValid measures of sexual violence stigma that can be readily incorporated into program monitoring and evaluation systems are needed to strengthen gender-based violence (GBV) services in humanitarian emergencies. This study sought to assess the psychometric properties, construct validity, and measurement invariance of sexual violence stigma scales among female Somali GBV survivors in Kenya and Syrian GBV survivors in Jordan to identify an abbreviated scale that could be used across humanitarian contexts.MethodsWe administered measures of sexual violence stigma to 209 female survivors of sexual violence aged 15 and older in Kenya and Jordan. Exploratory factor analysis was used to assess the underlying latent structure, and Item Response Theory was used to estimate item difficulty and discrimination parameters to guide efforts to shorten the scales. Differential item functioning (DIF) by site was assessed using Multiple Indicators, Multiple Causes models. Construct validity of the sexual violence stigma scales was assessed by estimating correlations with functional impairment, depression, and disability.ResultsThe sexual violence stigma measure exhibited distinct factor structures among Somali and Syrian GBV survivors. Among Somali survivors, a two-factor model with separate felt (10 items) and enacted (4 items) stigma constructs was identified, with scales for both domains exhibiting good internal consistency (Cronbach's alpha = 0.93 and 0.88, respectively). In Jordan, a single factor solution was uncovered for a 15-item stigma scale with good internal consistency (alpha = 0.86). The shortened core sexual stigma scale consisting of the 4 items that did not exhibit DIF had a Cronbach's alpha of 0.82 in Kenya and 0.81 in Jordan. The felt stigma scale in Kenya, the full stigma scale in Jordan, and abbreviated core stigma scales in both countries were meaningfully correlated with depression, while correlations with functional impairment were weaker and inconsistent across scales.ConclusionsAn abbreviated core set of invariant perceived and internalized sexual violence stigma items demonstrated evidence of construct validity in two diverse settings. The ability of this measure to be efficiently administered as a part of routine program monitoring and evaluation activities, with the potential addition of items from a measurement bank to improve contextual relevance, can facilitate improvements in the delivery and quality of gender-based violence programs in humanitarian emergencies.

Dataset Information

Obstetric Outcomes of Mothers Previously Exposed to Sexual Violence.

Background

Methods

Results

Conclusion

Publications

Obstetric Outcomes of Mothers Previously Exposed to Sexual Violence.

Similar Datasets

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