The prevalence and associated factors of adverse pregnancy outcomes among Afghan women in Iran; Findings from community-based survey

Backgrounds An estimated 2.5 million Afghans are living in the Iran and almost half of them are young women at the childbearing ages. Although the evidence indicates lower rates of antenatal care and higher incidence of pregnancy complications in Afghan compared to Iranian women, the underlying reasons are not well defined. Therefore, in the present study, we aimed to explore the prevalence and associated sociodemographic factors of adverse pregnancy outcomes and examine the impact of intimate partner violence, food insecurity, poor mental health, and housing issues on pregnancy outcome in Afghan women living in Iran. Methods In July 2019, we enrolled 424 Afghan women aged 18–44 years old using the time-location sampling at three community health centers in the south region of Tehran province. The data was collected through face to face interviews using the researcher-developed questionnaire. Using bivariate and multivariate analysis, the impact of poor antenatal care, intimate partner violence, food insecurity, and poor mental health was assessed on the incidence of adverse pregnancy outcome. Results More than half (56.6%) of Afghan women reported at least one pregnancy complication in their recent pregnancy. The results showed that undocumented, illiterate, and unemployed Afghan women with lower socioeconomic status are more likely to experience adverse pregnancy outcomes. Furthermore, we observed lower prevalence of adverse pregnancy outcomes among documented immigrants with health insurance compared to those with no health insurance. It is also been found that the food insecurity [Adjusted OR = 3.35, 95% CI (1.34–8.36)], poor antenatal care [Adjusted OR = 10.50, 95% CI (5.40–20.39)], intimate partner violence [Adjusted OR = 2.72, 95% CI (1.10–6.77)], and poor mental health [Adjusted OR = 4.77, 95% CI (2.54–8.94)] could adversely impact the pregnancy outcome and we observed higher incidence of adverse outcomes among those suffering from these situations. Conclusion To our knowledge, this is the first study that explored the prevalence and associated factors of adverse pregnancy outcomes and the impact of intimate partner violence, food insecurity, poor mental health on pregnancy outcome among Afghan women in Iran. Enhancing the psychosocial support and empowering Afghan women through expanding the social network and safety net should be a priority for the central government and international parties. Psychological counseling should be incorporated into routine maternity care for Afghan refugees. Access to free antenatal care is a right for all Afghan women and it should be facilitated by universal health insurance for all Afghans regardless of their legal status.

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The prevalence and associated factors of adverse pregnancy outcomes among Afghan women in Iran; findings from community-based survey

10.1101/2020.08.05.20168708 ◽

2020 ◽

Author(s):

Omid Dadras ◽

Takeo Nakayam ◽

Masahiro Kihara ◽

Masako Ono-Kihara ◽

Seyedahmad Seyedalinaghi ◽

...

Keyword(s):

Mental Health ◽

Intimate Partner Violence ◽

Antenatal Care ◽

Pregnancy Outcomes ◽

Partner Violence ◽

Intimate Partner ◽

Poor Mental Health ◽

Adverse Pregnancy Outcomes ◽

Afghan Women ◽

Adverse Pregnancy

AbstractBackgroundsAn estimated 2.5 million Afghans are living in the Iran and almost half of them are young women at the childbearing ages. Although the evidence indicates lower rates of antenatal care and higher incidence of pregnancy complications in Afghan compared to Iranian women, the underlying reasons are not well defined. Therefore, in the present study, we aimed to explore the prevalence and associated sociodemographic factors of adverse pregnancy outcomes and examine the impact of intimate partner violence, food insecurity, poor mental health, and housing issues on pregnancy outcome in Afghan women living in Iran.MethodsIn July 2019, we enrolled 424 Afghan women aged 18-44 years old using the time-location sampling at three community health centers in the south region of Tehran province. The data was collected through face to face interviews using the researcher-developed questionnaire. Using bivariate and multivariate analysis, the impact of poor antenatal care, intimate partner violence, food insecurity, and poor mental health was assessed on the incidence of adverse pregnancy outcome.ResultsMore than half (56.6%) of Afghan women reported at least one pregnancy complication in their recent pregnancy. The results showed that undocumented, illiterate, and unemployed Afghan women with lower socioeconomic status are more likely to experience adverse pregnancy outcomes. Furthermore, we observed lower prevalence of adverse pregnancy outcomes among documented immigrants with health insurance compared to those with no health insurance. It is also been found that the food insecurity [Adjusted OR = 3.35, 95% CI (1.34-8.36)], poor antenatal care [Adjusted OR = 10.50, 95% CI (5.40-20.39)], intimate partner violence [Adjusted OR = 2.72, 95% CI (1.10-6.77)], and poor mental health [Adjusted OR = 4.77, 95% CI (2.54-8.94)] could adversely impact the pregnancy outcome and we observed higher incidence of adverse outcomes among those suffering from these situations.ConclusionTo our knowledge, this is the first study that explored the prevalence and associated factors of adverse pregnancy outcomes and the impact of intimate partner violence, food insecurity, poor mental health on pregnancy outcome among Afghan women in Iran. Enhancing the psychosocial support and empowering Afghan women through expanding the social network and safety net should be a priority for the central government and international parties. Psychological counseling should be incorporated into routine maternity care for Afghan refugees. Access to free antenatal care is a right for all Afghan women and it should be facilitated by universal health insurance for all Afghans regardless of their legal status.

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Association between Intimate Partner Violence during Pregnancy and Adverse Pregnancy Outcomes in Vietnam: A Prospective Cohort Study

PLoS ONE ◽

10.1371/journal.pone.0162844 ◽

2016 ◽

Vol 11 (9) ◽

pp. e0162844 ◽

Cited By ~ 16

Author(s):

Thanh Nguyen Hoang ◽

Toan Ngo Van ◽

Tine Gammeltoft ◽

Dan W. Meyrowitsch ◽

Hanh Nguyen Thi Thuy ◽

...

Keyword(s):

Intimate Partner Violence ◽

Cohort Study ◽

Prospective Cohort Study ◽

Pregnancy Outcomes ◽

Partner Violence ◽

Prospective Cohort ◽

Intimate Partner ◽

Adverse Pregnancy Outcomes ◽

Violence During Pregnancy ◽

Adverse Pregnancy

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Intimate partner violence and adverse pregnancy outcomes: A population-based study

American Journal of Obstetrics and Gynecology ◽

10.1067/mob.2003.274 ◽

2003 ◽

Vol 188 (5) ◽

pp. 1341-1347 ◽

Cited By ~ 195

Author(s):

Patricia A. Janssen ◽

Victoria L. Holt ◽

Nancy K. Sugg ◽

Irvin Emanuel ◽

Cathy M. Critchlow ◽

...

Keyword(s):

Intimate Partner Violence ◽

Pregnancy Outcomes ◽

Partner Violence ◽

Population Based ◽

Intimate Partner ◽

Adverse Pregnancy Outcomes ◽

Population Based Study ◽

Adverse Pregnancy

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378: Intimate partner violence and adverse pregnancy outcomes

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2008.09.406 ◽

2008 ◽

Vol 199 (6) ◽

pp. S114 ◽

Cited By ~ 2

Author(s):

Matthew Garabedian ◽

Kristine Lain ◽

Wendy Hansen ◽

Lisandra Garcia ◽

Ann Coker ◽

...

Keyword(s):

Intimate Partner Violence ◽

Pregnancy Outcomes ◽

Partner Violence ◽

Intimate Partner ◽

Adverse Pregnancy Outcomes ◽

Adverse Pregnancy

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Ethiopian Health Care Workers’ Insights into and Responses to Intimate Partner Violence in Pregnancy—A Qualitative Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17103745 ◽

2020 ◽

Vol 17 (10) ◽

pp. 3745

Author(s):

Bosena Tebeje Gashaw ◽

Berit Schei ◽

Kari Nyheim Solbraekke ◽

Jeanette H. Magnus

Keyword(s):

Health Care ◽

Intimate Partner Violence ◽

Antenatal Care ◽

Health Care Workers ◽

Pregnancy Outcomes ◽

Partner Violence ◽

Intimate Partner ◽

Adverse Impacts ◽

Care Workers ◽

In Pregnancy

Violence against women is a global pandemic, with the potential to spread through generations. Intimate partner violence has impacts on women’s sexual, reproductive, and psycho-social health. It can occur during pregnancy and adversely affect the health of both mother and child. Health care workers involved in antenatal care can have a unique role in identifying intimate partner violence and in intervening, preventing, and mitigating its consequences. In this study, the objective was to explore Ethiopian health care workers’ insights of and responses to intimate partner violence in pregnancy. Using an exploratory design, this qualitative study includes ten semi-structured interviews of health care workers representing different antenatal care centers in Jimma, Ethiopia. The content analyses of translated interview notes were conducted with Atlas.ti7 software, (Atlas.ti Scientific Software Development Gmbh, Berlin). The health care workers shared their insights of the consequences of intimate partner violence during pregnancy in addition to their experience with and responses to the victims. There was a limited understanding of the extent of the adverse impacts of intimate partner violence on pregnancy outcomes, as well as the potential long-term health implications. The informants described how they only gave medical treatment for obstetric complications or visible trauma during pregnancy. There was no formal referral to or linkages with other resources. Women’s empowerment and systemic changes in the health care, including training and capacity building, clear guidelines addressing management of intimate partner violence in pregnancy, and inclusion of intimate partner violence screening tools in the Ethiopian antenatal care chart/card, were recommended by the informants. The adverse impacts of intimate partner violence on pregnancy outcomes were poorly understood by the Ethiopian health care workers in this study. They offered limited assistance to the victims and recommended changes in the routine antenatal care (ANC) and health care systems. They identified various policy initiatives focusing on women’s empowerment to reduce intimate partner violence and its complications especially during pregnancy.

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Vulnerability to intimate partner violence and poor mental health in the first 4-year postpartum among mothers reporting childhood abuse: an Australian pregnancy cohort study

Archives of Women s Mental Health ◽

10.1007/s00737-016-0659-8 ◽

2016 ◽

Vol 19 (6) ◽

pp. 1091-1100 ◽

Cited By ~ 12

Author(s):

D. Gartland ◽

H. Woolhouse ◽

R. Giallo ◽

E. McDonald ◽

K. Hegarty ◽

...

Keyword(s):

Mental Health ◽

Intimate Partner Violence ◽

Cohort Study ◽

Childhood Abuse ◽

Partner Violence ◽

Intimate Partner ◽

Poor Mental Health ◽

Pregnancy Cohort

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Telling Medical Professionals About Victimization by Intimate Partner: Analysis of Women Surviving Intimate Partner Violence

International Journal of Health Services ◽

10.1177/0020731419896695 ◽

2019 ◽

Vol 50 (2) ◽

pp. 129-136

Author(s):

Tyrone C. Cheng ◽

Celia C. Lo

Keyword(s):

Mental Health ◽

Intimate Partner Violence ◽

Ethnic Minority ◽

Partner Violence ◽

Intimate Partner ◽

Health Problems ◽

Poor Mental Health ◽

Medical Services ◽

Outcome Variable ◽

Medical Professionals

This study investigated factors in women’s disclosure of intimate partner violence (IPV) to medical professionals. Its sample of 3,226 women surviving IPV was extracted from the National Intimate Partner and Sexual Violence Survey public-use dataset, dated 2010. The dichotomous outcome variable was told medical professional about IPV. Explanatory variables were physical violence experienced in the past year, need for medical services for IPV, injury, fear, poor physical health, number of health problems, poor mental health, African American, Latina, other ethnic minority, education, family income, inability to afford seeing doctor, age, and being married. Logistic regression results showed likelihood of IPV disclosure increased with 31 or more physical IPV episodes in preceding year, needed medical services for IPV, IPV-related injury, 2 or more health problems, fear of partner, poor mental health, inability to afford seeing doctor, and age 55 and over. Disclosure likelihood was decreased by other ethnic minority and absence of high school graduation. Our findings support standardized protocols identifying recent IPV, IPV injury, and multiple health problems, along with corresponding response training for medical professionals. Our findings also support making victim advocates and behavioral health specialists available in medical facilities to address patients’ fears and mental health.

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Experiences of Intimate Partner and Neighborhood Violence and Their Association With Mental Health in Pregnant Women

Journal of Interpersonal Violence ◽

10.1177/0886260515613346 ◽

2015 ◽

Vol 33 (6) ◽

pp. 938-959 ◽

Cited By ~ 8

Author(s):

Veronica Barcelona de Mendoza ◽

Emily W. Harville ◽

Jane Savage ◽

Gloria Giarratano

Keyword(s):

Mental Health ◽

Intimate Partner Violence ◽

Health Outcomes ◽

Pregnant Women ◽

Partner Violence ◽

Intimate Partner ◽

Poor Mental Health ◽

Cumulative Exposure ◽

Neighborhood Violence ◽

Probable Depression

Both intimate partner violence and neighborhood crime have been associated with worse mental health outcomes, but less is known about cumulative effects. This association was studied in a sample of pregnant women who were enrolled in a study of disaster exposure, prenatal care, and mental and physical health outcomes between 2010 and 2012. Women were interviewed about their exposure to intimate partner violence and perceptions of neighborhood safety, crime, and disorder. Main study outcomes included symptoms of poor mental health; including depression, pregnancy-specific anxiety (PA), and posttraumatic stress disorder (PTSD). Logistic regression was used to examine predictors of mental health with adjustment for confounders. Women who experienced high levels of intimate partner violence and perceived neighborhood violence had increased odds of probable depression in individual models. Weighted high cumulative (intimate partner and neighborhood) experiences of violence were also associated with increased odds of having probable depression when compared with those with low violence. Weighed high cumulative violence was also associated with increased odds of PTSD. This study provides additional evidence that cumulative exposure to violence is associated with poorer mental health in pregnant women.

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