Effects of Intimate Partner Physical Violence on Newborns’ Birth Outcomes among Jordanian Birthing Women

Intimate partner physical violence against women (VAW) during pregnancy is a common experience all over the world. In Jordan, the number is double the reported international average. Data on effect of violence on birth outcomes are important for planning, implementing, and evaluating maternal health programs. 

The research question was, “Does intimate partner physical VAW during pregnancy increase the risk of negative birth outcomes for newborns among birthing women in Jordan?” Natural experiment design was used for this study. A consecutive sampling technique was used for selecting the victims of physical violence (n = 79) and a simple random sampling for selecting non-victims (n = 79). Intimate partner physical violence was measured by using the Arabic version of World Health Organization’s (WHO) domestic violence questionnaire, which has an accepted interrater validity. Analysis of covariance (ANCOVA) and chi-square were used to detect the differences in birth outcomes between the victims and non-victims of physical violence. 

The results showed that there is a significant difference in newborn’s birth weight between the victims of violence and non-victims with a small effect size. However, there were no significant differences between the two groups in preterm birth and assisted newborn ventilation. The non-significant effect of violence on the incidence of preterm birth contradicts the published literature. Intimate partner violence (IPV) is rooted in Jordanian culture and widely accepted among married Jordanian women. 

Midwives, doctors, educators, and policy makers should work together to eradicate violence and detect victims of it, to improve birth outcomes and decrease newborn morbidity and mortality rates.

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By:   Sanaa Abujilban, PhD1, Lina Mrayan, PhD1, Hanan Al-Modallal, PhD1, Esra’a Isaa, BSc1

1. ¹Hashemite University College of Nursing, Zarqa, Jordan

1. Sanaa Abujilban, Faculty of Nursing, Department of Maternal, Child, and Family Health Nursing, Hashemite University, P.O. Box 330127, Zarqa 13133, Jordan. Email:abujelban@yahoo.co.uk

 

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Pre-Pregnancy Dating Violence and Birth Outcomes among Adolescent Mothers in a National Sample

Although infants born to adolescent mothers are at increased risk of adverse birth outcomes, little is known about contributors to birth outcomes in this group. Given past research linking partner abuse to adverse birth outcomes among adult mothers, we explored associations between pre-pregnancy verbal and physical dating violence and the birthweight and gestational age of infants born to adolescent mothers.

Data from the National Longitudinal Study of Adolescent Health Waves I (1995/96), II (1996), and IV (2007/08) were analyzed. Girls whose first singleton live births occurred after Wave II interview and before age 20 (n=558) self-reported infants’ birth weight and gestational age at Wave IV. Dating violence victimization (verbal and physical) in the 18 months prior to Wave II interview was self-reported. Controls included Wave I age; parent education; age at pregnancy; time between reporting abuse and birth; and childhood physical and sexual abuse. Weighted multivariable regression models were performed separately by race (Black/non-Black).

On average, births occurred two years after Wave II interview. Almost one in four mothers reported verbal dating violence victimization (23.6%), and 10.1% reported physical victimization. Birthweight and prevalence of verbal dating violence victimization were significantly lower in Black compared to non-Black teen mothers. In multivariable analyses, negative associations between physical dating abuse and birth outcomes became stronger as time increased for Black mothers. For example, pre-pregnancy physical dating abuse was associated with 0.79 kilograms lower birthweight (p<.001) and 4.72 fewer weeks gestational age (p<0.01) for Black mothers who gave birth two years post-reporting abuse. Physical dating abuse was unassociated with birth outcomes among non-Black mothers, and verbal abuse was unassociated with birth outcomes for all mothers.

Reducing physical dating violence in adolescent relationships prior to pregnancy may improve Black adolescent mothers’ birth outcomes. Intervening on long-term violence may be particularly important.

Below:  Predicted birthweight among Black girls comparing those with and without pre-pregnancy physical dating abuse

Below:  Predicted gestational age among Black girls comparing those with and without pre-pregnancy physical dating abuse

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By: Aubrey Spriggs Madkour, PhD, Yiqiong Xie, MPH, and Emily W. Harville, PhD
Department of Global Community Health & Behavioral Sciences, Tulane University 1440 Canal Street, suite 2301, New Orleans, LA 70112