학술논문

Intimate partner violence and severe acute maternal morbidity in the intensive care unit: A case‐control study in Peru.
Document Type
Article
Source
Birth: Issues in Perinatal Care. Mar2020, Vol. 47 Issue 1, p29-38. 10p. 1 Diagram, 4 Charts.
Subject
*CHILD health services
*CONFIDENCE intervals
*DISEASES
*GOODNESS-of-fit tests
*INFANT mortality
*INTENSIVE care units
*LONGITUDINAL method
*EVALUATION of medical care
*MEDICAL records
*MISCARRIAGE
*MATERNAL mortality
*MULTIVARIATE analysis
*PREGNANCY
*PREGNANCY complications
*PRENATAL care
*RESEARCH funding
*RISK assessment
*STATISTICS
*MULTIPLE regression analysis
*CASE-control method
*INTIMATE partner violence
*DATA analysis software
*DESCRIPTIVE statistics
*HOSPITAL mortality
*ACQUISITION of data methodology
*ODDS ratio
Language
ISSN
0730-7659
Abstract
Background: Intimate partner violence is a prevalent public health issue associated with all‐cause maternal mortality. This study investigated the relationship between intimate partner violence, severe acute maternal morbidity in the intensive care unit (ICU), and neonatal outcomes. Methods: This was a prospective case‐control study in a hospital in Lima, Peru, with 109 cases (maternal ICU admissions) and 109 controls (obstetric patients not admitted to the ICU). Data were collected through face‐to‐face interviews and medical record review. Partner violence was assessed using the World Health Organization instrument. Multivariate logistic regression was used to model the association between intimate partner violence and severe acute maternal morbidity. Results: There was a significantly higher rate of intimate partner violence both before and during pregnancy among cases (58.7%) than controls (27.5%). In multivariate analysis, intimate partner violence both before and during pregnancy (aOR 3.83 (95% CI: 1.99‐7.37)), being married (3.86 (1.27‐11.73)), having <8 antenatal care visits (2.78 (1.14‐6.80)), and having previous abortions (miscarriage, therapeutic, or unsafe) (1.69 (1.13‐2.51)) were significantly associated with severe acute maternal morbidity. The ICU admission rate was 18.8 (per 1000 live births), and ICU maternal mortality was 1.7%. The perinatal mortality rate was higher in cases (9.3%) than in controls (1.8%). Conclusions: Intimate partner violence was associated with an increased risk of severe acute maternal morbidity. This suggests a more severe impact of intimate partner violence on pregnancy than has been previously identified. Inquiring about intimate partner violence during prenatal visits may prevent further harm to the mother‐baby dyad. [ABSTRACT FROM AUTHOR]