Abstract
Objectives Even during pregnancy women may suffer from violence. We estimated the prevalence of physical abuse during pregnancy, we analyzed the main risk factors and described the relationship between physical violence, psychological wellbeing and pregnancy outcome. Methods We used a national representative sample of births, in all public and private maternity units, in 2016 in France. Women were interviewed after delivery, on their living conditions and occurrence of physical violence at least once during pregnancy. The study of risk factors and pregnancy outcome was done with multivariable logistic regressions. Results Of 12,330 women included in the analysis 1.8% (95% CI 1.6–2.0) had been exposed to physical violence during pregnancy. Risk of violence was associated with the couple situation [women without a partner or in couple not cohabiting (OR 2.89, 95% CI 1.96–4.26)], household income (less than 3000 euros monthly), and state medical assistance coverage. Physical violence was more prevalent in case of a history of induced abortion or cannabis use during pregnancy. Psychological distress was more frequent with than without physical violence (e.g., 62% vs. 24% had a sadness period during pregnancy, p < 0.001). The risk of spontaneous preterm birth and transfer of the newborn to a neonatal intensive care unit were significantly higher among women experiencing physical violence during pregnancy compared to other women. Conclusions for Practice Main factors associated with increased risk of violence during pregnancy were socio-economics. The identification by caregivers of women exposed to violence during pregnancy needs to be improved to develop preventive and care strategies.
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Acknowledgements
The authors thank Bénédicte Coulm and Camille Bonnet for their work in the data collection and the preparation of data files and their colleagues Brigitte Lhomond and Pierre-Yves Ancel for their useful comments on the draft paper. They are grateful to the midwives, secretaries and physicians of the maternity units and to members of PMI (maternal and child protection) services for their collaboration in collecting the data. They thank the women who agreed to take time to answer to this survey.
Funding
The funding of the NPS was granted by the French ministry of health [Direction de la Recherche, des Etudes, de l’Evaluation et des Statistiques (DREES), Direction Générale de la Santé (DGS) and Direction Générale de l’Organisation des Soins (DGOS)] and by Santé Publique France. During her stay in Paris, one of the authors has received a grant from Brazil, “Bolsista da Capes/Programa de doutorado sanduíche no exterior/Processo no. {88881.132432/2016-01}”.
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Maciel, M.N.A., Blondel, B. & Saurel-Cubizolles, MJ. Physical Violence During Pregnancy in France: Frequency and Impact on the Health of Expectant Mothers and New-Borns. Matern Child Health J 23, 1108–1116 (2019). https://doi.org/10.1007/s10995-019-02747-y
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DOI: https://doi.org/10.1007/s10995-019-02747-y