Dataset Information

The Importance of Intimate Partner Violence in Within-Relationship and Between-Person Risk for Alcohol-Exposed Pregnancy.

ABSTRACT: BACKGROUND:Preconceptual prevention programs geared toward reducing alcohol-exposed pregnancy (AEP) typically emphasize behavioral change of alcohol use and birth control exclusively, but rarely consider other important AEP predictors that may affect behavioral change. Intimate partner violence (IPV) substantially relates to AEP and to AEP predictors; however, few studies have tested if IPV is a unique indicator of prospective AEP risk, as both a main effect and a contextual influence on alcohol use or birth control. METHODS:Using Waves II and III of the National Longitudinal Study of Adolescent to Adult Health, multilevel logistic regression models were estimated, in which IPV and birth control (both within-person and between-person) and adolescent alcohol use (between-person only) were examined as unique predictors of AEP compared to both nonpregnancy and non-AEP (nAEP) outcomes over up to 5 sexual relationships. Interactions between within-person and between-person IPV, and birth control or alcohol use were also tested. RESULTS:Within-person and between-person IPV significantly related to higher odds of AEP compared to nonpregnancy and nAEP. Adolescent alcohol use had similarly increased odds for AEP when compared to nonpregnancy or nAEP outcomes. Only between-person birth control use related to higher odds for AEP compared to nonpregnancy and nAEP. Between-person IPV also moderated adolescent alcohol use on odds of AEP, such that infrequent adolescent drinkers had higher odds of AEP compared to nonpregnancy or nAEP if they experienced IPV over their relationships. CONCLUSIONS:IPV is a substantial predictor for AEP as both a direct influence within relationships (within-person) and between individuals (between-person). Intervention and prevention programs focused on reducing AEP may benefit from including IPV-specific curricula.

SUBMITTER: Deutsch AR

PROVIDER: S-EPMC6443449 | biostudies-literature | 2019 Apr

REPOSITORIES: biostudies-literature

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The Importance of Intimate Partner Violence in Within-Relationship and Between-Person Risk for Alcohol-Exposed Pregnancy.

Deutsch Arielle R AR

Alcoholism, clinical and experimental research 20190220 4

<h4>Background</h4>Preconceptual prevention programs geared toward reducing alcohol-exposed pregnancy (AEP) typically emphasize behavioral change of alcohol use and birth control exclusively, but rarely consider other important AEP predictors that may affect behavioral change. Intimate partner violence (IPV) substantially relates to AEP and to AEP predictors; however, few studies have tested if IPV is a unique indicator of prospective AEP risk, as both a main effect and a contextual influence on ...[more]

PMID: 30698820

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Project description:BackgroundIntimate partner violence (IPV) is a significant global public health issue. The consistent evidence that alcohol use by one or both partners contributes to the risk and severity of IPV suggests that interventions that reduce alcohol consumption may also reduce IPV. This study sought to review the evidence for effects on IPV of alcohol interventions at the population, community, relationship and individual levels using the World Health Organization ecological framework for violence.MethodsEleven databases including Medline, PsycINFO, CINAHL and EMBASE were searched for English-language studies and grey literature published 1 January 1992 - 1 March 2013 investigating whether alcohol interventions/policies were associated with IPV reduction within adult (? 18) intimate relationships. Eleven studies meeting design criteria for attributing effects to the intervention and ten studies showing mediation of alcohol consumption were included in the review. The heterogeneity of study designs precluded quantitative meta analysis; therefore, a critical narrative approach was used.ResultsPopulation-level pricing and taxation studies found weak or no evidence for alcohol price changes influencing IPV. Studies of community-level policies or interventions (e.g., hours of sale, alcohol outlet density) showed weak evidence of an association with IPV. Couples-based and individual alcohol treatment studies found a relationship between reductions in alcohol consumption and reductions in IPV but their designs precluded attributing changes to treatment. Randomized controlled trials of combined alcohol and violence treatment programs found some positive effects of brief alcohol intervention as an adjunct to batterer treatment for hazardous drinking IPV perpetrators, and of brief interventions with non-dependent younger populations, but effects were often not sustained.ConclusionsDespite evidence associating problematic alcohol use with IPV, the potential for alcohol interventions to reduce IPV has not been adequately tested, possibly because studies have not focused on those most at risk of alcohol-related IPV. Research using rigorous designs should target young adult populations among whom IPV and drinking is highly prevalent. Combining alcohol and IPV intervention/policy approaches at the population, community, relationship and individual-level may provide the best opportunity for effective intervention.

Project description:BackgroundIntimate partner violence (IPV) around the time of pregnancy is a widespread global health problem with many negative consequences. Nevertheless, a lot remains unclear about which interventions are effective and might be adopted in the perinatal care context.ObjectiveThe objective is to provide a clear overview of the existing evidence on effectiveness of interventions for IPV around the time of pregnancy.MethodsFollowing databases PubMed, Web of Science, CINAHL and the Cochrane Library were systematically searched and expanded by hand search. The search was limited to English peer-reviewed randomized controlled trials published from 2000 to 2013. This review includes all types of interventions aiming to reduce IPV around the time of pregnancy as a primary outcome, and as secondary outcomes to enhance physical and/or mental health, quality of life, safety behavior, help seeking behavior, and/or social support.ResultsWe found few randomized controlled trials evaluating interventions for IPV around the time of pregnancy. Moreover, the nine studies identified did not produce strong evidence that certain interventions are effective. Nonetheless, home visitation programs and some multifaceted counseling interventions did produce promising results. Five studies reported a statistically significant decrease in physical, sexual and/or psychological partner violence (odds ratios from 0.47 to 0.92). Limited evidence was found for improved mental health, less postnatal depression, improved quality of life, fewer subsequent miscarriages, and less low birth weight/prematurity. None of the studies reported any evidence of a negative or harmful effect of the interventions.Conclusions and implicationsStrong evidence of effective interventions for IPV during the perinatal period is lacking, but some interventions show promising results. Additional large-scale, high-quality research is essential to provide further evidence about the effect of certain interventions and clarify which interventions should be adopted in the perinatal care context.

Project description: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.

Dataset Information

The Importance of Intimate Partner Violence in Within-Relationship and Between-Person Risk for Alcohol-Exposed Pregnancy.

Publications

The Importance of Intimate Partner Violence in Within-Relationship and Between-Person Risk for Alcohol-Exposed Pregnancy.

Similar Datasets

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