A systematic review and meta-analysis of intimate partner violence during pregnancy and selected birth outcomes

Abstract

Background: Intimate partner violence (IPV) has a detrimental impact on the lives of women worldwide. Several studies have examined the effect IPV has on adverse birth outcomes when it occurs during pregnancy.

Objectives: To explore the association between IPV and selected adverse birth outcomes.

Search strategy: Multiple databases were searched to identify studies investigating the association between IPV and low birth weight (LBW), preterm birth, and/or intrauterine growth restriction (IUGR).

Selection criteria: Included studies defined the perpetrator of violence as an intimate partner, the type of violence as physical and/or sexual, and the study outcomes as LBW, preterm birth, or IUGR, with violence preceding delivery.

Data collection and analysis: Random-effects meta-analysis was used to calculate adjusted/unadjusted odds ratios (ORs). Subanalyses explored the effect of emotional/psychological violence on birth outcomes.

Main results: Nineteen studies met the inclusion criteria (15 LBW, 12 preterm birth, 4 IUGR). IPV was associated with LBW (OR 1.18, 95% confidence interval 1.05-1.31; I(2)=0.70, P<0.001) and preterm birth (OR 1.42, 95% confidence interval 1.21-1.63; I(2)=0.20, P<0.001). No statistically significant association was found for IUGR.

Conclusions: There are associations between IPV and LBW and preterm birth that could be causal.

Keywords: Intimate partner violence; Low birth weight; Meta-analysis; Physical violence; Pregnancy; Preterm birth; Sexual violence; Systematic review.