'I will rather be killed by corona than by him ': Experiences of abused women seeking shelter during South Africa's COVID-19 lockdown.

BACKGROUND: In April 2020, the United Nations predicted that the COVID-19 pandemic will have a 'calamitous' impact on the lives of women. This was based on concerns about an upsurge in Intimate Partner Violence (IPV) arising from increased opportunities for relational conflict due to forced co-existence and therefore additional time spent with abusive partners. AIM: Research has shown an increase in IPV during times of crisis. The COVID-19 pandemic has generated unprecedented circumstances and stress, and opportunities to do research to understand whether the COVID-19 pandemic impacted on IPV experiences were limited. Thus, the present study aimed to understand women's experiences of being in and leaving an abusive relationship during the COVID-19 pandemic. METHODS: Individual, telephonic interviews were conducted with 16 women living in domestic violence shelters within three Provinces during South Africa's lockdown period. RESULTS: Findings reveal that the public health measures implemented by the South African Government to curb the spread of the virus, may have placed vulnerable groups at increased risk of violence. Specifically, lockdown likely magnified the risk for escalation of abuse in families already experiencing IPV prior to COVID-19. The study highlights an IPV and COVID-19 relationship, showing that the gender insensitive pandemic control measures, such as stay at home orders and travel restrictions, likely placed women at risk of increased abuse. Given the recurrency of COVID-19 epidemic waves, attention must be given to gender disparities or many South African women may experience worse outcomes. CONCLUSION: This study reminds us that being ordered to stay at home is not always the safest option for women and thus, in a country with one of the highest levels of GBV, it becomes imperative to ensure that IPV safeguards are integrated into COVID-19 measures. It also becomes evident that COVID-19 requires enhanced ways of responding by paying attention to gender disparities.

The Endemic Amid the Pandemic: Seeking Help for Violence Against Women in the Initial Phases of COVID-19.

During the first months of the COVID-19 pandemic, governments instituted a series of measures to control the spread of the virus. The measures were widely believed to increase women's risk of violent victimization, most of which is by an intimate partner. We examined help-seeking during this period in a large U.S. city and used an interrupted time series analysis to assess the effects of three government interventions on domestic violence and sexual assault hotline calls and on "911" calls regarding domestic violence, assault, and rape. Declaration of an emergency appeared to reduce victim calls to the rape crisis hotline and the few "911" calls about rape. School closure was associated with a reduction in "911" calls about assault and rape and victim calls to the domestic violence hotline. Implementation of stay-at-home orders was associated with a gradual increase in domestic violence hotline calls. Although "911" calls regarding assault fell by nearly half, calls to police for domestic violence were unchanged. In sum, there was a decrease in help-seeking for sexual assault and assault in general but not for domestic violence during the initial phases of the COVID-19 outbreak. The analysis underscores the importance of distinguishing between the violence itself, calls to police, and calls to helplines when claims are made about changes over time in violence against women. The opportunities and constraints for each can differ widely under usual circumstances, circumstances that were altered by public health interventions related to the pandemic.

Drinking Context-Specific Dose-Response Models of Intimate Partner Violence Among an Urban Emergency Department Sample.

OBJECTIVE: This cross-sectional study evaluates the association between physical intimate partner violence (IPV) and frequencies of drinking and volume consumed in six different contexts among a sample of urban emergency department (ED) patients. METHOD: We obtained survey data from 1,037 married, cohabiting, or partnered patients (53% female; 50% Hispanic; 29% African American) at a Northern California safety-net hospital. Past-year physical IPV was measured with the Revised Conflict Tactics Scale. We asked patients about frequency of drinking and usual number of drinks consumed at bars, restaurants, homes of friends or relatives, own home, public places such as street corners or parking lots, and community centers or large events. Gender-stratified dose-response models were estimated for frequencies of IPV perpetration and victimization, with adjustment for sociodemographic and psychosocial factors, marijuana use, and spouse/partner problem drinking. RESULTS: None of the women's context-based frequency and volume measures were associated with frequency of IPV victimization. Women's volume of alcohol consumed at home was associated positively with frequency of their IPV perpetration (ß = .008, SE = .003, p < .01), and volume consumed in public places was associated negatively with this outcome (ß = -.023, SE = .010, p < .05). Among men, none of the context-based frequency and volume measures were associated with frequency of either IPV outcome. Spouse/partner's problem drinking was associated with each gender's IPV victimization, and with IPV perpetration by men. CONCLUSIONS: Frequency of drinking and volume consumed in specific contexts do not substantively contribute to frequency of IPV perpetration or victimization in this sample of urban ED patients.

COVID-19, Lockdown, and Intimate Partner Violence: Some Data from an Italian Service and Suggestions for Future Approaches.

Intimate partner violence (IPV)-defined as physical, psychological, sexual, and/or economic violence typically experienced by women at home and perpetrated by their partners or expartners-is a pervasive form of violence that destroys women's feelings of love, trust, and self-esteem, with important negative consequences on physical and psychological health. Many reports from several countries have underlined a remarkable increase in the cases of IPV during the COVID-19 emergency. In this opinion article, we discussed the hypothesis that such an increase may be related to the restrictive measures enacted to contain the pandemic, including women's forced cohabitation with the abusive partner, as well as the exacerbation of partners' pre-existing psychological disorders during the lockdown. In addition, we retrospectively analyzed some data derived from our practice in a public Italian referral center for sexual and domestic violence (Service for Sexual and Domestic Violence [SVSeD]). These data interestingly revealed an opposite trend, that is, a decrease in the number of women who sought assistance since the beginning of the COVID-19 outbreak. Such a reduction should be interpreted as a negative consequence of the pandemic-related restrictive measures. Although necessary, these measures reduced women's possibilities of seeking help from antiviolence centers and/or emergency services. Owing to the COVID-19 outbreak, there is an urgent need for developing and implementing alternative treatment options for IPV victims (such as online and phone counseling and telemedicine), as well as training programs for health care professionals, especially those employed in emergency departments, to facilitate early detection of IPV.

Predictors of Intimate Partner Homicide in a Sample of Portuguese Male Domestic Offenders.

Intimate partner homicide (IPH) is a major social problem, and it is important to determine the predictors of this violent behavior. The purpose of this study was to examine the differences between intimate partner violence (IPV) and IPH and to identify the variables that predict IPH. The sample was composed of 35 perpetrators of IPH, who were compared with 137 perpetrators of IPV. The data were collected using the Spousal Abuse Risk Assessment. The data suggest that IPH presents different dynamics from IPV. Being older, exhibiting suicidal and/or homicidal ideation/intent, and the use of weapons and/or credible threats of death substantially increase a man's risk of committing IPH. Inversely, not being single, violating conditional release, and being victimized in childhood decrease the likelihood of committing IPH. These findings reinforce the assumption that IPV and IPH have both commonalities and differences and challenge the view that IPV and IPH are different phenomena and that intimate partner murder is an inexplicable event. Implications for preventing IPV and IPH are discussed.

Women's Healthcare Utilization Following Routine Screening for Past-Year Intimate Partner Violence in the Veterans Health Administration.

BACKGROUND: Experience of intimate partner violence (IPV) can have adverse health impacts and has been associated with elevated rates of healthcare service utilization. Healthcare encounters present opportunities to identify IPV-related concerns and connect patients with services. The Veterans Health Administration (VHA) conducts IPV screening within an integrated healthcare system. OBJECTIVE: The objectives of this study were to compare service utilization in the 6 months following IPV screening between those screening positive and negative for past-year IPV (IPV+, IPV-) and to examine the timing and types of healthcare services accessed among women screening IPV+. DESIGN: A retrospective chart review was conducted for 8888 female VHA patients across 13 VHA facilities who were screened for past-year IPV between April 2014 and April 2016. MAIN MEASURES: Demographic characteristics (age, race, ethnicity, marital status, veteran status), IPV screening response, and healthcare encounters (based on visit identification codes). KEY RESULTS: In the 6 months following routine screening for past-year IPV, patients screening IPV+ were more likely to utilize outpatient care (aOR = 1.85 [CI 1.26, 2.70]), including primary care or psychosocial care, and to have an inpatient stay (aOR = 2.09 [CI 1.23, 3.57]), compared with patients screening IPV-. Among those with any utilization, frequency of outpatient encounters within the 6-month period following screening was higher among those screening IPV+ compared with those screening IPV-. The majority of patients screening positive for past-year IPV returned for an outpatient visit within a brief time frame following the screening visit (> 70% within 14 days, >95% within 6 months). More than one in four patients screening IPV+ had an emergency department visit within the 6 months following screening. CONCLUSIONS: Women who screen positive for past-year IPV have high rates of return to outpatient visits following screening, presenting opportunities for follow-up support. Higher rates of emergency department utilization and inpatient stays among women screening IPV+ may indicate adverse health outcomes related to IPV experience.

Maternal mental health priorities, help-seeking behaviors, and resources in post-conflict settings: a qualitative study in eastern Uganda.

BACKGROUND: Limited knowledge exists to inform the selection and introduction of locally relevant, feasible, and effective mental health interventions in diverse socio-cultural contexts and health systems. We examined stakeholders' perspectives on mental health-related priorities, help-seeking behaviors, and existing resources to guide the development of a maternal mental health component for integration into non-specialized care in Soroti, eastern Uganda. METHODS: We employed rapid ethnographic methods (free listing and ranking; semi-structured interviews; key informant interviews and pile sorting) with community health workers (n = 24), primary health workers (n = 26), perinatal women (n = 24), traditional and religious healers (n = 10), and mental health specialists (n = 9). Interviews were conducted by trained Ateso-speaking interviewers. Two independent teams conducted analyses of interview transcripts following an inductive and thematic approach. Smith's Salience Index was used for analysis of free listing data. RESULTS: When asked about common reasons for visiting health clinics, the most salient responses were malaria, general postnatal care, and husbands being absent. Amongst the free listed items that were identified as mental health problems, the three highest ranked concerns were adeka na aomisio (sickness of thoughts); ipum (epilepsy), and emalaria (malaria). The terms epilepsy and malaria were used in ways that reflected both biomedical and cultural concepts of distress. Sickness of thoughts appeared to overlap substantially with major depression as described in international classification, and was perceived to be caused by unsupportive husbands, intimate partner violence, chronic poverty, and physical illnesses. Reported help-seeking for sickness of thoughts included turning to family and community members for support and consultation, followed by traditional or religious healers and health centers if the problem persisted. CONCLUSION: Our findings add to existing literature that describes 'thinking too much' idioms as cultural concepts of distress with roots in social adversity. In addition to making feasible and effective treatment available, our findings indicate the importance of prevention strategies that address the social determinants of psychological distress for perinatal women in post-conflict low-resource contexts.

Violencia hacia la mujer por su pareja. Centro de Salud Mental. Aguada de Pasajeros, 2014 / Violence toward woman from the part of her couple. Mental Health Center. Aguada de Pasajeros, 2014

Introducción: la violencia afecta a una de cada tres mujeres alguna vez en la vida. Cuando es producida por su pareja constituye un suceso destructor, generador de tensión, angustia y peligro para la vida. Objetivo: caracterizar la violencia hacia la mujer por su pareja en los casos asistidos en el Centro de Salud Mental de Aguada de Pasajeros, provincia de Cienfuegos, durante el año 2014. Materiales y métodos: se realizó una investigación descriptiva transversal, en 45 mujeres asistidas en el Centro de Salud Mental de Aguada de Pasajeros, provincia de Cienfuegos. Fueron utilizadas las técnicas de análisis documental, entrevistas, test de detección de tipos de violencia y de diagnóstico de violencia en la pareja. Resultados: predominaron las edades entre 26 y 35 años en un 46,6 %. En cuanto a nivel cultural el medio superior, con un 46,6 %. Se apreció un 66,6 %) de uniones consensuales. El 46,6 % ocupaban plazas técnicas. Estuvo presente la violencia física y psicológica en la totalidad de las féminas, la sexual en 15 mujeres y la económica en 38. La mayoría (23) estaban expuestas a un segundo grado de violencia. Prevalecieron sentimientos de culpa, temor a la soledad y relacionan la violencia con el consumo de bebidas alcohólicas. Conclusiones: se detectó en las mujeres estudiadas violencia psicológica, física, económica y sexual; de diferentes niveles, desde una relación violenta hasta una violencia peligrosa. Prevaleció el segundo nivel de violencia y creencias erróneas acerca de los roles de género de las mujeres maltratadas y de los hombres violentos (AU).

Introduction: violence affects one of every three women some time in her life. When it is caused by her couple it becomes a destructive fact, generating tension, anguish and danger for her life. Objective: to characterize violence toward women from the part of her couple in the cases attended at the Mental Health Center of Aguada de Pasajeros, province of Cienfuegos, during 2014. Materials and methods: a cross-sectional, descriptive research was carried out in 45 women attended at the Mental Health Center of Aguada de Pasajeros, province of Cienfuegos. The used techniques were documental analysis, interviews, tests for detecting the kind of violence, and tests for diagnosing violence in the couple. Results: ages between 26 and 35 years predominated for a 46,6 %. According to the scholarship, high school prevailed, with 46,6 %. A 66,6 % of consensual unions were found. 46,6 % of women worked as technicians. Physical and social violence was found in the total of women, the sexual one in 15 women, and the economic one in 38. Most of them (23) were exposed to a second degree of violence. The prevailing feelings were guiltiness, solitude fear and a link of violence with alcohol consumption. Conclusions: sexual, economic, physical and psychological violence was found in the studied women, in different levels, from a violent relationship to a dangerous violence. The second level of violence and erroneous beliefs on the genre roles of the abused women and the violent men prevailed (AU).

Violencia hacia la mujer por su pareja. Centro de Salud Mental. Aguada de Pasajeros, 2014 / Violence toward woman from the part of her couple. Mental Health Center. Aguada de Pasajeros, 2014

Introducción: la violencia afecta a una de cada tres mujeres alguna vez en la vida. Cuando es producida por su pareja constituye un suceso destructor, generador de tensión, angustia y peligro para la vida. Objetivo: caracterizar la violencia hacia la mujer por su pareja en los casos asistidos en el Centro de Salud Mental de Aguada de Pasajeros, provincia de Cienfuegos, durante el año 2014. Materiales y métodos: se realizó una investigación descriptiva transversal, en 45 mujeres asistidas en el Centro de Salud Mental de Aguada de Pasajeros, provincia de Cienfuegos. Fueron utilizadas las técnicas de análisis documental, entrevistas, test de detección de tipos de violencia y de diagnóstico de violencia en la pareja. Resultados: predominaron las edades entre 26 y 35 años en un 46,6 %. En cuanto a nivel cultural el medio superior, con un 46,6 %. Se apreció un 66,6 %) de uniones consensuales. El 46,6 % ocupaban plazas técnicas. Estuvo presente la violencia física y psicológica en la totalidad de las féminas, la sexual en 15 mujeres y la económica en 38. La mayoría (23) estaban expuestas a un segundo grado de violencia. Prevalecieron sentimientos de culpa, temor a la soledad y relacionan la violencia con el consumo de bebidas alcohólicas. Conclusiones: se detectó en las mujeres estudiadas violencia psicológica, física, económica y sexual; de diferentes niveles, desde una relación violenta hasta una violencia peligrosa. Prevaleció el segundo nivel de violencia y creencias erróneas acerca de los roles de género de las mujeres maltratadas y de los hombres violentos (AU).

Introduction: violence affects one of every three women some time in her life. When it is caused by her couple it becomes a destructive fact, generating tension, anguish and danger for her life. Objective: to characterize violence toward women from the part of her couple in the cases attended at the Mental Health Center of Aguada de Pasajeros, province of Cienfuegos, during 2014. Materials and methods: a cross-sectional, descriptive research was carried out in 45 women attended at the Mental Health Center of Aguada de Pasajeros, province of Cienfuegos. The used techniques were documental analysis, interviews, tests for detecting the kind of violence, and tests for diagnosing violence in the couple. Results: ages between 26 and 35 years predominated for a 46,6 %. According to the scholarship, high school prevailed, with 46,6 %. A 66,6 % of consensual unions were found. 46,6 % of women worked as technicians. Physical and social violence was found in the total of women, the sexual one in 15 women, and the economic one in 38. Most of them (23) were exposed to a second degree of violence. The prevailing feelings were guiltiness, solitude fear and a link of violence with alcohol consumption. Conclusions: sexual, economic, physical and psychological violence was found in the studied women, in different levels, from a violent relationship to a dangerous violence. The second level of violence and erroneous beliefs on the genre roles of the abused women and the violent men prevailed (AU).

Domestic violence against women in India: A systematic review of a decade of quantitative studies.

Domestic violence (DV) is prevalent among women in India and has been associated with poor mental and physical health. We performed a systematic review of 137 quantitative studies published in the prior decade that directly evaluated the DV experiences of Indian women to summarise the breadth of recent work and identify gaps in the literature. Among studies surveying at least two forms of abuse, a median 41% of women reported experiencing DV during their lifetime and 30% in the past year. We noted substantial inter-study variance in DV prevalence estimates, attributable in part to different study populations and settings, but also to a lack of standardisation, validation, and cultural adaptation of DV survey instruments. There was paucity of studies evaluating the DV experiences of women over age 50, residing in live-in relationships, same-sex relationships, tribal villages, and of women from the northern regions of India. Additionally, our review highlighted a gap in research evaluating the impact of DV on physical health. We conclude with a research agenda calling for additional qualitative and longitudinal quantitative studies to explore the DV correlates proposed by this quantitative literature to inform the development of a culturally tailored DV scale and prevention strategies.

How do area-level socioeconomic status and gender norms affect partner violence against women? Evidence from Tanzania.

OBJECTIVES: To explore how area-level socioeconomic status and gender-related norms influence partner violence against women in Tanzania. METHODS: We analysed data from the 2010 Tanzania Demographic and Health Survey and used multilevel logistic regression to estimate individual and community-level effects on women's risk of current partner violence. RESULTS: Prevalence of current partner violence was 36.1 %; however, variation in prevalence exists across communities. Twenty-nine percent of the variation in the logodds of partner violence is due to community-level influences. When adjusting for individual-level characteristics, this variation falls to 10 % and falls further to 8 % when adjusting for additional community-level factors. Higher levels of women's acceptance towards wife beating, male unemployment, and years of schooling among men were associated with higher risk of partner violence; however, higher levels of women in paid work were associated with lower risk. CONCLUSIONS: Area-level poverty and inequitable gender norms were associated with higher risk of partner violence. Empowerment strategies along with addressing social attitudes are likely to achieve reductions in rates of partner violence against women in Tanzania and in other similar low-income country settings.

Prevalence of Intimate Partner Violence among Women Veterans who Utilize Veterans Health Administration Primary Care.

OBJECTIVES: The objectives of this study were to identify the prevalence of past-year intimate partner violence (IPV) among women Veterans utilizing Veterans Health Administration (VHA) primary care, and to document associated demographic, military, and primary care characteristics. DESIGN: This was a retrospective cohort design, where participants completed a telephone survey in 2012 (84% participation rate); responses were linked to VHA administrative data for utilization in the year prior to the survey. PARTICIPANTS: A national stratified random sample of 6,287 women Veteran VHA primary care users participated in the study. MAIN MEASURES: Past-year IPV was assessed using the HARK screening tool. Self-report items and scales assessed demographic and military characteristics. Primary care characteristics were assessed via self-report and VHA administrative data. KEY RESULTS: The prevalence of past-year IPV among women Veterans was 18.5% (se = 0.5%), with higher rates (22.2% - 25.5%) among women up to age 55. Other demographic correlates included indicators of economic hardship, lesbian or bisexual orientation, and being a parent/guardian of a child less than 18 years old. Military correlates included service during Vietnam to post-Vietnam eras, less than 10 years of service, and experiences of Military Sexual Trauma (MST). Most (77.3%, se = 1.2%) women who experienced IPV identified a VHA provider as their usual provider. Compared with women who did not report past-year IPV, women who reported IPV had more primary care visits, yet experienced lower continuity of care across providers. CONCLUSIONS: The high prevalence of past-year IPV among women beyond childbearing years, the majority of whom primarily rely on VHA as a source of health care, reinforces the importance of screening all women for IPV in VHA primary care settings. Key considerations for service implementation include sensitivity with respect to sexual orientation, race/ethnicity, and other aspects of diversity, as well as care coordination and linkages with social services and MST-related care.

Development and validation of the scale of psychological abuse in intimate partner violence (EAPA-P) / Desarrollo y validación de la Escala de Abuso Psicológico Aplicado en la Pareja (EAPA-P)

BACKGROUND: In the context of intimate partner violence, psychological abuse (PA) has progressively gained scientific relevance. Even so, a greater effort is needed to define and evaluate psychological intimate partner abuse. A new exhaustive and operative taxonomy of PA strategies leads to the contribution of a new evaluation instrument. METHOD: Participants were 101 women between 24 and 82 years old, who were abused by their partners and attended to in different municipal Catalan services, specialized in the topic. RESULTS: The analyses have shown the suitability of a 19-item instrument divided into two factors: (1) direct PA strategies and (2) indirect PA strategies. The former includes strategies that affect the emotional, cognitive and behavioral dimension of the victim. The latter includes items that measure the amount of control and domination over the victim's context. This scale has adequate psychometric properties in terms of score reliability and the validity of the relationship with other women's health variables. CONCLUSIONS: The EAPA-P, created based on a new definition and taxonomy of the forms of PA, is presented as a valid instrument to detect and measure intimate partner PA

ANTECEDENTES: en el contexto de la violencia en la pareja, la de tipo psicológico ha ido ganando relevancia científica. Aun así, es preciso un mayor esfuerzo para delimitar y evaluar el abuso psicológico (AP) en la pareja. Una nueva taxonomía de estrategias de AP da pie a la aportación de un nuevo instrumento de evaluación. MÉTODO: han participado 101 mujeres maltratadas por su pareja, de entre 24 y 82 años, y atendidas en diferentes servicios municipales especializados en el tema. RESULTADOS: los análisis han mostrado la idoneidad de un instrumento de 19 ítems distribuidos en dos factores: (1) estrategias directas de AP y (2) estrategias indirectas de AP. El primero agrupa las estrategias que inciden en la dimensión emocional, cognitiva y conductual de la víctima. El segundo recoge aquellas que persiguen el control y la dominación sobre el contexto de la misma. Dicha escala posee propiedades psicométricas adecuadas en lo que se refiere a la fiabilidad de las puntuaciones y la validez de relación con otras variables relacionadas con la salud. CONCLUSIONES: la EAPA-P se presenta como herramienta válida para detectar y medir el AP en la pareja

Maltrato prenatal / Prenatal maltreatment

No disponible

Screening and counseling for Intimate Partner Violence: a vision for the future.

We describe a vision of screening and intervention for Intimate Partner Violence informed by deliberations during the December 2013 Intimate Partner Violence Screening and Counseling Research Symposium and the resultant manuscripts featured in this special issue of the Journal of Women's Health. Our vision includes universal screening and intervention, when indicated, which occurs routinely as part of comprehensive physical and behavioral health services that are both patient centered and trauma informed. Areas for future research needed to realize this vision are discussed.

Applying the WHO recommendations on health-sector response to violence against women to assess the Spanish health system. A mixed methods approach / La aplicación de las recomendaciones de la OMS sobre la respuesta del sector salud a la violencia contra las mujeres para evaluar el sistema sanitario español

This methodological note describes the development and application of a mixed-methods protocol to assess the responsiveness of Spanish health systems to violence against women in Spain, based on the World Health Organization (WHO) recommendations. Five areas for exploration were identified based on the WHO recommendations: policy environment, protocols, training, accountability/monitoring, and prevention/promotion. Two data collection instruments were developed to assess the situation of 17 Spanish regional health systems (RHS) with respect to these areas: 1) a set of indicators to guide a systematic review of secondary sources, and 2) an interview guide to be used with 26 key informants at the regional and national levels.We found differences between RHSs in the five areas assessed. The progress of RHSs on the WHO recommendations was notable at the level of policies, moderate in terms of health service delivery, and very limited in terms of preventive actions. Using a mixed-methods approach was useful for triangulation and complementarity during instrument design, data collection and interpretation (AU)

Esta nota metodológica describe el desarrollo de un protocolo de investigación que utiliza métodos mixtos para evaluar la respuesta del sistema sanitario español a la violencia contra las mujeres, partiendo de las recomendaciones de la Organización Mundial de la Salud (OMS).A partir de estas recomendaciones, se definieron cinco áreas para su evaluación: políticas, protocolos, formación, rendición de cuentas/monitoreo, y acciones de prevención y promoción. Se desarrollaron dos instrumentos - un conjunto de indicadores para orientar la revisión sistemática de fuentes secundarias, y una guía de entrevista, que se utilizó con 26 informantes clave - y se aplicaron en los 17 sistemas sanitarios autonómicos. Se evidenciaron diferencias entre autonomías y entre las cinco áreas evaluadas: notable progreso en políticas, menos destacado en la prestación de servicios y muy limitados en acciones preventivo-promocionales. Combinar métodos permitió lograr triangulación, complementariedad y desarrollo, durante el diseño de los instrumentos, la recogida de información y su interpretación (AU)

Intimate partner violence: associations with low infant birthweight in a South African birth cohort.

Violence against women is a global public health problem. Exposure to intimate partner violence (IPV) during pregnancy has been associated with a number of adverse maternal and fetal outcomes, including delivery of a low birthweight (LBW) infant. However, there is a paucity of data from low-middle income countries (LMIC). We examined the association between antenatal IPV and subsequent LBW in a South African birth cohort. This study reports data from the Drakenstein Child Lung Health Study (DCLHS), a multidisciplinary birth cohort investigation of the influence of a number of antecedent risk factors on maternal and infant health outcomes over time. Pregnant women seeking antenatal care were recruited at two different primary care clinics in a low income, semi-rural area outside Cape Town, South Africa. Antenatal trauma exposure was assessed using the Childhood Trauma Questionnaire (CTQ) and an IPV assessment tool specifically designed for the purposes of this study. Potential confounding variables including maternal sociodemographics, pregnancy intention, partner support, biomedical and mental illness, substance use and psychosocial risk were also assessed. Bivariate and multiple regression analyses were performed to determine the association between IPV during pregnancy and delivery of an infant with LBW and/or low weight-for-age z (WAZ) scores. The final study sample comprised 263 mother-infant dyads. In multiple regression analyses, the model run was significant [r2 = 0.14 (adjusted r2 = 0.11, F(8, 212) = 4.16, p = 0.0001]. Exposure to physical IPV occurring during the past year was found to be significantly associated with LBW [t = -2.04, p = 0.0429] when controlling for study site (clinic), maternal height, ethnicity, socioeconomic status, substance use and childhood trauma. A significant association with decreased WAZ scores was not demonstrated. Exposure of pregnant women to IPV may impact newborn health. Further research is needed in this field to assess the relevant underlying mechanisms, to inform public health policies and to develop appropriate trauma IPV interventions for LMIC settings.