Physical violence during pregnancy and pregnancy outcomes in Ghana

BMC Pregnancy and Childbirth

Charles Agyemang²  Ank de Jonge¹  Ellis Owusu-Dabo³  Easmon Otupiri³  Michelle Sharon Pool² 

[1] Midwifery Science, AVAG and the EMGO, Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands;Department of Public Health, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands;Department of Community Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana

关键词: Neonatal mortality;    Perinatal mortality;    Early pregnancy loss;    Intimate partner violence;    Domestic violence;   

Others  :  1127591
DOI  :  10.1186/1471-2393-14-71

 received in 2013-05-18, accepted in 2014-02-11,  发布年份 2014

【 摘 要 】

Background

In pregnancy, violence can have serious health consequences that could affect both mother and child. In Ghana there are limited data on this subject. We sought to assess the relationship between physical violence during pregnancy and pregnancy outcomes (early pregnancy loss, perinatal mortality and neonatal mortality) in Ghana.

Method

The 2008 Ghana Demographic and Health Survey data were used. For the domestic violence module, 2563 women were approached of whom 2442 women completed the module. After excluding missing values and applying the weight factor, 1745 women remained. Logistic regression analysis was performed to assess the relationship between physical violence in pregnancy and adverse pregnancy outcomes with adjustments for potential confounders.

Results

About five percent of the women experienced violence during their pregnancy. Physical violence in pregnancy was positively associated with perinatal mortality and neonatal mortality, but not with early pregnancy loss. The differences remained largely unchanged after adjustment for age, parity, education level, wealth status, marital status and place of residence: adjusted odds ratios were 2.32; 95% CI: 1.34-4.01 for perinatal mortality, 1.86; 95% CI: 1.05-3.30 for neonatal mortality and 1.16; 95% CI: 0.60-2.24 for early pregnancy loss.

Conclusion

Our findings suggest that violence during pregnancy is related to adverse pregnancy outcomes in Ghana. Major efforts are needed to tackle violence during pregnancy. This can be achieved through measures that are directed towards the right target groups. Measures should include education, empowerment and improving socio-economic status of women.

【 授权许可】

   
2014 Pool et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

【 参考文献 】

• [1]United Nations Development Fund for Women UNIFEM National Committee for UNIFEM: Commemorating 10 Years of Commitment to women’s Empowerment and Gender Equality. Singapore: Double Six Press Pte Ltd; 2010:p14.
• [2]United Nations International Children’s Emergency Fund (UNICEF): Domestic violence against women and children. http://www.unicef-irc.org/publications/pdf/digest6e.pdf webcite
• [3]GarcÍa-Moreno C, Jansen HAFM, Ellsberg M, Heise L, Watts C: World Health Organization multi-country study on Women’s health and domestic violence against women: initial results on prevalence, health outcomes and women’s responses. http://www.who.int/gender/violence/who_multicountry_study/en/ webcite
• [4]Ahmed S, Koenig MA, Stephenson R: Effects of domestic violence on perinatal and early-childhood mortality: evidence from North India. Am J Public Health 2006, 96(8):1423-1428.
• [5]Alio AP, Nana PN, Salihu HM: Spousal violence and potentially preventable single and recurrent spontaneous fetal loss in an African setting: cross-sectional study. Lancet 2009, 373(9660):318-324.
• [6]Bohn DK: Lifetime and current abuse, pregnancy risks, and outcomes among native American women. J Health Care Poor Underserved 2002, 13(2):184-198.
• [7]Coker AL, Sanderson M, Dong B: Partner violence during pregnancy and risk of adverse pregnancy outcomes. Paediatr Perinat Epidemiol 2004, 18(4):260-269.
• [8]Cokkinides VE, Coker AL, Sanderson M, Addy C, Bethea L: Physical violence during pregnancy: maternal complications and birth outcomes. Obstet Gynecol 1999, 93(5 Pt 1):661-666.
• [9]Dunn LL, Oths KS: Prenatal predictors of intimate partner abuse. J Obstet Gynecol Neonatal Nurs 2004, 33(1):54-63.
• [10]Emenike E, Lawoko S, Dalal K: Intimate partner violence and reproductive health of women in Kenya. Int Nurs Rev 2008, 55(1):97-102.
• [11]Janssen PA, Holt VL, Sugg NK, Emanuel I, Critchlow CM, Henderson AD: Intimate partner violence and adverse pregnancy outcomes: a population-based study. Am J Obstet Gynecol 2003, 188:1341-1347.
• [12]Rachana C, Suraiya K, Hisham A, Abdulaziz A, Hai A: Prevalence and complications of physical violence during pregnancy. Eur J Obstet Gynecol Reprod Biol 2002, 103(1):26-29.
• [13]Romero-Guttiérrez G, Cruz-Arvizu VH, Regalado-Cedillo CA, Ponce-Ponce de León AL: Prevalence of violence against pregnant women and associated maternal and neonatal complication in Leon, Mexico. Midwifery 2011, 27:750-753.
• [14]Shah PS, Shah J: Maternal exposure to domestic violence and pregnancy and birth outcomes: a systematic review and meta-analyses. J Womens Health (Larchmt) 2010, 19(11):2017-2031.
• [15]Shoffner DH: We don’t like to think about it intimate partner violence during pregnancy and postpartum. J Perinat Neonatal Nurs 2008, 22(1):39-48.
• [16]Sarkar NN: The impact of intimate partner violence on women’s reproductive health and pregnancy outcome. J Obstet Gynecol 2008, 28:266-271.
• [17]Chambliss LR: Intimate partner violence and its implication for pregnancy. Clin Obstet Gynecol 2008, 51:385-397.
• [18]Poole GV, Martin JN Jr, Perry KG Jr, Griswold JA, Lambert J, Rhodes RS: Trauma in pregnancy: the role of interpersonal violence. Am J Obstet Gynecol 1996, 174:1873-1877.
• [19]United Nations: Millennium development goals indicators. The official United Nations site for the MDG indicators. http://mdgs.un.org/unsd/mdg/Resources/Attach/Indicators/OfficialList2008.pdf webcite
• [20]Ghana Statistical Service (GSS), Ghana Health Service (GHS) and ICF Macro: Ghana Demographic and Health Survey 2008. http://www.measuredhs.com/pubs/pdf/FR221/FR221[13Aug2012].pdf webcite
• [21]Binka FN, Maude GH, Gyapong M, Ross DA, Smith PG: Risk factors for child mortality in northern Ghana: a case-control study. Int J Epidemiol 1995, 24:127-135.
• [22]Country Health System Fact Sheet 2006 Ghana. World Health Organization, Africa http://www.afro.who.int/index.php?option=com_docman&task=doc_download&gid=37 webcite
• [23]Ghana Statistical Service: Ghana Population and Housing Census; Summary Report of Final Results 2012. Ghana: Accra; 2010.
• [24]World Health Organization: Global health observatory data repository – WHO African region. http://apps.who.int/ghodata/?region=afro webcite
• [25]MEASURE DHS Demographic and Health Surveys http://www.measuredhs.com webcite
• [26]Department of Gender and Women’s Health, Family and Community Health, World Health Organization (WHO): Putting women first: Ethical and Safety Recommendations for Research on Domestic Violence Against Women. Geneva: World Health Organization; 2001. Report No.: WHO/FCH/GWH/01.1. [http://whqlibdoc.who.int/hq/2001/WHO_FCH_GWH_01.1.pdf webcite]
• [27]Yost NP, Bloom SL, McIntire DD, Leveno KJ: A prospective observational study of domestic violence during pregnancy. Obstet Gynecol 2005, 106(1):61-65.
• [28]Ghana Police Service Official Website, Domestic Violence and Victim Support Unit (DOVVSU) http://www.ghanapolice.info/dvvsu/dvvsu.htm webcite
• [29]Fanslow J, Silva M, Whitehead A, Robinson E: Pregnancy outcomes and intimate partner violence in New Zealand. Aust N Z J Obstet Gynaecol 2008, 48:391-397.
• [30]Silverman JG, Gupta J, Decker MR, Kapur N, Raj A: Intimate partner violence and unwanted pregnancy, miscarriage, induced abortion, and stillbirth among a national sample of Bangladeshi women. BJOG 2007, 114:1246-1252.
• [31]Amoakohene MI: Violence against women in Ghana: a look at women’s perceptions and review of policy and social responses. Soc Sci Med 2004, 59(11):2373-2385.
• [32]Republic of Ghana. Ministry of women and Children’s affairs http://www.mowacghana.net webcite
• [33]Takyiwaa Manuh, University of Ghana: Pathways of women’s empowerment. The passage of domestic violence legislation in Ghana. http://www.pathwaysofempowerment.org/GhanaDV.pdf webcite