Dataset Information

Identifying health correlates of intimate partner violence against pregnant women.

ABSTRACT:

Purpose

Violence against women during pregnancy is a serious public health concern due to its significant adverse health consequences for both the mother and the baby. This study aims to systematically identify common health problems and synergistic health correlates of intimate partner violence (IPV) that specifically affect pregnant women.

Methods

We mine large-scale electronic health record (EHR) data from the IBM Explorys database to identify health problems that are prevalent in both IPV and pregnancy populations, as well those that are synergistically associated with the presence of IPV during pregnancy. For this purpose, we develop methods that enhance the statistical reliability of identified patterns by constructing confidence intervals that take into account systematic bias and measurement errors in addition to the variance in estimation.

Results

We identify with high confidence 668 and 2750 terms that are respectively prevalent in respectively IPV and pregnancy populations. Of these terms, 279 are common. We also identify 16 synergistic health correlates with high confidence. Our results suggest that mental health, substance abuse, and genitourinary complications are prevalent among pregnant women exposed to IPV. The synergistic terms we identify reveal potential conditions that can be direct consequences of trauma (e.g., tibial fracture), long-term health consequences (e.g., chronic rhinitis), markers associated with the demograhics of affected populations (e.g., acne), and risk factors that potentially increase vulnerability during pregnancy (e.g., disorders of attention and motor control).

Conclusions

Our results indicate that IPV significantly affects the well-being of pregnant women in multiple ways. The findings of this study can be useful for screening of IPV in pregnant women. Finally, the methodology presented here can also be useful for investigating the synergy between other medical conditions using EHR databases with privacy constraints.

SUBMITTER: Yılmaz S

PROVIDER: S-EPMC7561659 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundIntimate partner violence (IPV) against pregnant women is a recognized global public health problem affecting all spheres of women and unborn infants. In Ethiopia, although inconsistent, individual studies avail; there is a dearth of systematic reviews and meta-analysis about the prevalence and associated factors of intimate partner violence. Thus, the present study was aimed at determining the pooled prevalence of IPV and its determinant factors during pregnancy.MethodsThe report of meta-analysis follows the Preferred Reporting Items for Systematic Review and Meta-Analysis 20 guideline (PRISMA 20). Databases including PubMed/Medline, CINAHL, SCOPUS, HINARI (research4life), AJOL, IRIS, and AIM were searched. Heterogeneity test was assessed by the Cochrane chi-square (χ2) and quantified by I 2 statistics test. Publication bias was tested by funnel plots and Egger's test. Sensitivity test and subgroup analysis were also performed. Effect size was calculated by random effects model.ResultsA total of 26 studies, including data from 13, 912 participants, were included in the analysis. The prevalence of IPV ranged from 7% to 81% with overall estimated pooled prevalence of 37% (30% -44%, I 2 = 96.5%, p ≤ 0.001). Of this, the prevalence of physical, sexual, and psychological violence was 24% (95% CI; 19%-30%), 21% (95% CI; 16%-26%), and 27% (95% CI; 22%-32%), respectively. Factors such as lack of formal education, childhood violence, rural residency, low decision-making power, family history of violence, attitude, unplanned and unwanted pregnancy by women and partners, late initiation of antenatal care, partner alcohol, and khat use were associated with IPV.ConclusionMore than one-third of pregnant women experienced IPV. The most prevalent form of IPV was psychological violence followed by physical and sexual violence. The identified risk for IPV including victim, pregnancy, and perpetrator-related factors indicated the need of a holistic approach in the promotion, prevention, and treatment of IPV. The finding of this study suggests the need of strengthening women empowerments (capacity building) against traditional beliefs, attitudes, and practices. This study also suggests the need of evaluation and strengthening the collaborative work among different sectors such as policy-makers, service providers, administrative personnel, and community leaders, including the engagement of men partners.

Project description:IntroductionIntimate partner violence against women is one of the most common forms of violence. Different research fields are trying to understand the cycle of violence, such as the psychological field, to understand how these women's relational patterns and intrapsychic conflict function in the cycle of violence.ObjectiveTo investigate the operationalized psychodynamic diagnosis of women victims of domestic violence, exploring the severity and experience of violence, structural functions, dysfunctional interpersonal patterns, and intrapsychic conflicts.MethodWe conducted a cross-sectional quantitative study using the OPD-2 Clinical Interviews, which were recorded and transcribed. The sample was composed by 56 women victims of domestic violence, mean age 30.07 (SD = ±9.65). Reliability was satisfactory for judges interviews(k>0,6).ResultsAccording to the OPD-2 evaluation, we found that the severity of the violence was associated with the intensity of women's subjective suffering. In the relational pattern, they stay in the relationship, leaving themselves vulnerable; perceive the partner as controlling, aggressive, offensive, and fear abandonment. As a defensive mechanism to relational discomfort and suffering victims anticipate the aggressor's desire, resulting in submissive behavior. The main psychic conflict was the "need for care versus self-sufficiency" (78.6%). And medium was the predominant structure level, in which they presented insecure internal objects, presenting difficulties in emotional regulation and perceiving reality in a distorted way. Hence, they do not recognize their limitations and needs. We found that 78.6% of the cases had some psychiatric disorder: MDD, PTSD.ConclusionThis study provides empirical evidence on clinical observations on the psychological functioning of this population and the issues that make up the maintenance of domestic violence against women. The understanding of internalized patterns, structural functions, and motivational tensions are fundamental for the prevention of re-victimization and improving coping mechanisms, as well as promoting greater adherence to treatment.

Project description:IntroductionThe dynamics of intimate partner violence (IPV)-one of the world's leading public health problems-in urban Africa remain poorly understood. Yet, urban areas are key to the future of women's health in Africa.Study objectivesWe explored survivor-, partner-, and household-level correlates of prevalence rates for types of IPV in urban SSA women.MethodThe study uses DHS data from 42,143 urban women aged 15-49 in 27 SSA countries. Associations at the bivariate level were examined using the Pearson Chi-square test. The modified Poisson regression test estimated the relative prevalence of IPV subtypes in the study population at the multivariate level.ResultsApproximately 36% of women in urban SSA experienced at least one form of IPV; 12.8% experienced two types; and 4.6% experienced all three types. SSA urban women who had only primary-level education, had 3 or more living children, were informally employed, were in polygynous unions, or who approved of wife-beating similarly displayed higher adjusted prevalence rates for all three forms of IPV compared respectively to their counterparts without formal education, without a living child, were unemployed, in monogamous unions, or who do not approve of wife-beating. On the other hand, the region's urban women who began cohabiting between ages 25 and 35 years or who lived in higher wealth households showed consistently lower adjusted prevalence rates for all three forms of IPV relative to their counterparts who began cohabiting before 18 years or who lived in lower wealth households. Compared to their counterparts without formal education, without a living child, or whose partners did not have formal education, women with secondary and higher education, with 1-2 living children, or whose partners had only primary level schooling displayed higher adjusted prevalence rates for both IPEV and IPPV, but not for IPSV. However, relative to their counterparts whose partners were aged 25 years or below, living with a partner aged 40 years and above was associated with statistically significant reduced prevalence rates for IPPV and IPSV, but not for IPEV. Only for IPPV did women with partners educated at secondary and above levels display statistically significant higher adjusted prevalence rates relative to their counterparts with uneducated partners. Also, solely for IPPV did women who began cohabiting between ages 18 and 24 years or whose partners were employed (whether formally or informally) show decreased adjusted prevalence rates relative to their counterparts who started cohabiting before 18 years or whose partners were unemployed. In addition, only for IPSV did women aged 40 years and above or living in middle wealth households show statistically significant reduced adjusted prevalence rates relative to their counterparts aged less than 25 years or living in lower wealth households.Discussion and conclusionBy 2030, the majority of SSA women will be urban dwellers. Complexities surround IPV in urban SSA, highlighting the unique dynamics of the problem in this setting. While affirming the link between IPV and marital power inequities and dynamics, findings suggest that the specific correlates of prevalence rates for different IPV sub-types in urban SSA women can, at once, be both similar and unique. The contextual drivers of the differences and similarities in the correlates of the prevalence rates of IPV sub-types among the region's urban women need further interrogation.

Project description:BackgroundViolence against women is often studied in the context of violence from intimate partners. However, women receive violence from a wider range of individuals-such as their natal kin-including their siblings, parents, uncles and cousins. Applying insights from evolutionary theory, we examine whether cousin marriage, which has been hypothesized to both reduce the risk of partner violence but increase the risk of natal family violence, associates differently with each type of violence. Second, we test whether common risk factors for partner violence, such as wealth, associate similarly with natal violence.MethodologyWe analyse over 16 000 Jordanian women from three cohorts of the Jordan Demographic Health Surveys. Predictor variables include type of cousin marriage (patrilateral or matrilateral), education, wealth, number of children, urban living and polygyny. Outcome variables include whether a woman's husband or her natal family has ever been physically violent towards her.ResultsBeing married to a patrilateral cousin but not a matrilateral cousin is associated with a reduced risk of reporting intimate partner violence (IPV). By contrast being married to a matrilateral cousin but not a patrilateral one is associated with a reduced risk of reporting natal family violence. As expected, wealth is negatively associated with reporting partner violence, but we find no association with reports of natal family violence. Finally, individuals with more children are more likely to report IPV.Conclusions and implicationsFindings indicate the importance of distinguishing between types of cousin marriage and highlight substantial differences in risk factors for intimate partner compared to natal family violence.Lay summarySociodemographic risk factors, such as wealth, may associate differently with intimate partner and natal family violence. Results suggest that whether cousin marriage is protective of violence may depend on the type of cousin and secondly, that violence can have fitness relevant outcomes.