Intimate partner violence during pregnancy and its association with pregnancy and childbirth complications: A prospective cohort study

Intimate partner violence (IPV) during pregnancy increases the risk of adverse outcomes for both the woman and foetus. However, there is limited research on its scope and impact in many sub-Saharan African countries. In this study, we investigated the effects of IPV during pregnancy on pregnancy and childbirth complications in Ethiopia. Prospective, longitudinal data from the Performance Monitoring for Action Ethiopia (PMA Ethiopia) Cohort 1 study covering a sample of 2635 women followed up until one year postpartum was used for analysis. Information on IPV during pregnancy and obstetric complications were collected from women at six-week follow-up visits. Multivariable log-binomial regression estimated the risk of antepartum, intrapartum, and postpartum complications associated with IPV of any type, physical IPV and sexual IPV during pregnancy. The prevalence of any IPV type was 13%, only physical IPV was 4.6%, and only sexual IPV was 7.1%. Physical IPV was associated with an increased risk of worsening vision at night during pregnancy (adjusted relative risk [aRR]=2.47, 95% Confidence Interval [95%CI]=1.46 - 4.77), intrapartum haemorrhage (aRR=1.65, 95%CI=1.11 - 2.46), and intrapartum convulsion (aRR=1.98, 95%CI=1.34 - 2.94). Sexual IPV was associated with increased risk for antepartum convulsion (aRR=1.93, 95%CI=1.07 - 3.48), leaked/ruptured membrane (aRR=2.86, 95%CI=1.59 - 5.14), malpresentation (aRR=2.37, 95%CI=1.17 - 4.80), intrapartum convulsions (aRR=1.86, 95%CI=1.16 - 2.98), postpartum haemorrhage (aRR=1.68, 95%CI=1.18 - 2.40) and fever with foul discharge (aRR=2.03, 95%CI=1.40 - 2.93). Overall, the experience of any IPV type increased the risk for the above in addition to migraine, postpartum convulsion, and abnormal vaginal discharge. There is a need to embed IPV sensitisation campaigns in maternal health policies and interventions and to empower women to report cases for timely intervention.