Intimate partner violence during pregnancy and the associated perinatal outcomes at Moi Teaching and Referral Hospital in Eldoret, Kenya

Abstract

Background: Intimate Partner Violence (IPV) against women is the range of sexual, psychological and physical coercive acts used against adult and adolescent women by current or former male intimate partners (CDC, 2010). When this occurs in pregnancy, it directly or indirectly affects the mother leading to adverse maternal and perinatal outcomes. Locally, the prevalence of IPV in pregnancy (IPVp) is 37%. Determining the risk factors of IPVp would make it easier to identify affected pregnant women. It is also necessary to find out whether adverse perinatal outcomes occur in cases of IPVp. Objectives: To determine the prevalence, the types, the factors associated with and the perinatal outcomes of IPVp among women giving birth at Moi Teaching and Referral Hospital (MTRH). Methods: This was a cross-sectional study of 369 women who had just given birth and were admitted in the postnatal ward at MTRH. They were recruited using systematic sampling. Data was collected using a structured questionnaire which was modified from the WHO violence against women Tool. The analysis was done using the R Core Team 2017. Categorical variables were summarized as frequencies and percentages whereas continuous variables as mean, standard deviation, median and interquartile ranges. Logistic regression was used to assess the association between risk factors and the occurrence of IPVp. Results: The prevalence of IPVp was 37.1%. Stalking, physical, sexual and psychological IPVp were identified with psychological violence emerging as the most prevalent affecting 73.7% of the victims. There was an association between IPVp and partner alcohol and drug intake (adjusted odds ratio (aOR) 2.19), partner’s low level of income, partner not being the spouse, history of exposure to violence while young (aOR 3.02) and a previous history of IPV (aOR 25.77). Women who were exposed to physical IPVp were more likely to give birth to children who had low 5-minute APGAR scores (p = 0.014). There was no difference in age (p = 0.836), marital status (p = 0.529) and the type of employment (p = 0.914) between those who experienced IPVp and those who did not. Conclusion: IPVp was prevalent (37.1%) in this study. The types of IPVp identified were physical, sexual, stalking and psychological with the most common being the psychological type. Affected pregnant women were more likely to have been exposed to violence while young, to have experienced IPV previously, to have partners who were not their spouses, who took alcohol or drugs and who had a low level of income. When physical IPVp occurred, it was more likely to be associated with low APGAR scores. Recommendations: Pregnant women should be screened for IPVp. Policies to effect screening and identification of these women should be formulated to aid in curtailing the burden of IPVp. There is a need to conduct further studies to assess the causal inferences of physical IPVp and low APGAR scores.