Intimate Partner Violence During Pregnancy and Maternal Morbidity in South Ethiopia: A Cohort Study

Abstract

Purpose

Intimate partner violence during pregnancy is a universal public health problem. However, its link with maternal morbidity is not well understood in Ethiopia. Thus, the study assessed its effect on maternal morbidity during delivery and postpartum in South Ethiopia.

Methods

A prospective cohort study was conducted among 1535 pregnant women. Pregnant women with intimate partner violence during pregnancy were enrolled as the “exposed group”, and pregnant women without intimate partner violence were registered as the “unexposed group”. A total of 711 exposed and 774 unexposed women were included in the analysis of this study. Data were collected using an interviewer-administered questionnaire. Data entry and analysis were done in STATA Version 14. A generalized linear model with a log link function using the binreg command was applied to examine the effect of intimate partner violence on maternal morbidity.

Results

The level of maternal morbidity during delivery and postpartum was higher among women with intimate partner violence than women without intimate partner violence (34.0% vs 26.6%). After adjusting for confounders, women with intimate partner violence during pregnancy were more likely to experience maternal morbidity than women without intimate partner violence (aRR=4.45; 95% CI: 3.15, 6.28). Psychological violence was also identified as a risk factor for maternal morbidity (aRR=2.17; 95% CI: 1.76, 2.67). Likewise, women with physical violence were more likely to experience maternal morbidity than those without physical violence (aRR=1.31; 95% CI: 1.12, 1.53).

Conclusion

The current study demonstrated a higher level of maternal morbidity among women with intimate partner violence. Psychological violence, physical violence, and intimate partner violence during pregnancy were found to increase the risk of maternal morbidity. Strengthening the prevention and prompt management of intimate partner violence during pregnancy may significantly reduce the incidence of maternal morbidity.

Keywords:

• intimate partner
• violence
• morbidity
• cohort
• Ethiopia

Data Sharing Statement

The datasets used and / or analyzed during the current study are available from the corresponding author on reasonable request.

Ethics Approval and Informed Consent

This study was conducted in compliance with the ethical principles outlined by Helsinki declaration.⁵⁵ Accordingly, the study was approved for scientific and ethical integrity by the Institutional Review Board (IRB) of the College of Health Sciences of Addis Ababa University (Protocol number: 106/19/SPH). All necessary permissions were obtained from all local administrators. Written informed consent was sought from every study participant before actual data collection. For women under the age of 18, consent was obtained from their parents. The study strictly followed the WHO guideline on ethical issues related to violence research.³⁷ All interviews were conducted in complete privacy. Confidentiality was maintained by removing any identifier from the questionnaire. Data collectors were trained to provide necessary health information based on the needs of the study participants, but not an intervention. Furthermore, during data collection, women who were identified as sick were advised to seek examinations and treatment at nearby health facilities.

Acknowledgments

We are very grateful to Addis Ababa University for funding the data collection of this study. Thanks to Gamo Goffa Zone Department of Health and data collectors for their technical assistance. We are also indebted to the study participants for their willingness to participate in the research.

Author Contributions

All authors have made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; have drafted, revised or critically reviewed the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors declare that they have no competing interests.

Additional information

Funding

No funding was obtained from any funding agency. The data collection was conducted using a small grant provided by Addis Ababa University. The university has no role in the design of the study, collection, analysis and interpretation of the data. The finding and conclusion of the study reflect the view of the authors only.