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

<div><p>Background</p><p>Violence against pregnant women is an increasing public health concern particularly in low- and middle-income countries. The purpose of this study was to measure the association between intimate partner violence (IPV) during pregnancy and the risk of adverse birth outcomes.</p><p>Methods</p><p>Prospective cohort study of 1276 pregnant women in Dong Anh district, Vietnam. Women with gestational age less than 24 weeks were enrolled and interviewed. Repeated interviews were performed at 30–34 weeks gestation to assess experience of IPV during pregnancy and again 48 hours post-delivery to assess the birth outcome including birth weight and gestational age at delivery.</p><p>Results</p><p>There was a statistically significant association between exposure to physical violence during pregnancy and preterm birth (PTB) or low birth weight (LBW). After adjustment for age, education, occupation, body mass index (BMI), haemoglobin level, previous adverse pregnancy outcomes, the pregnant women who were exposed to physical violence during pregnancy were five times more likely to have PTB (AOR = 5.5; 95%CI: 2.1–14.1) and were nearly six times more likely to give birth to a child of LBW (AOR = 5.7; 95%CI: 2.2–14.9) as compared to those who were not exposed to physical violence.</p><p>Conclusion</p><p>Exposure to IPV during pregnancy increases the risk of PTB and LBW. Case-finding for violence in relation to antenatal care may help protect pregnant women and improve pregnancy outcomes.</p></div

The association between IPV during pregnancy and preterm birth.

<p>The association between IPV during pregnancy and preterm birth.</p

The association between IPV during pregnancy and low birth weight.

<p>The association between IPV during pregnancy and low birth weight.</p

The association between physical violence and PTB or LBW among women without previous adverse obstetric history and women with previous adverse obstetric history.

<p>The association between physical violence and PTB or LBW among women without previous adverse obstetric history and women with previous adverse obstetric history.</p

Association between different combinations of violence during pregnancy and birth outcome.

<p>Association between different combinations of violence during pregnancy and birth outcome.</p

Follow-up chart.

<p>Follow-up chart.</p

Socio-demographic background and prevalence of exposure to at least one type of violence during pregnancy.

<p>Socio-demographic background and prevalence of exposure to at least one type of violence during pregnancy.</p

Reasons given for not taking the drugs among the interviewed adult study populations from the four study sites in Lindi and Morogoro Region who reported not to have taken the drugs (n = 1403).

<p>Reasons given for not taking the drugs among the interviewed adult study populations from the four study sites in Lindi and Morogoro Region who reported not to have taken the drugs (n = 1403).</p

Factors Influencing Drug Uptake during Mass Drug Administration for Control of Lymphatic Filariasis in Rural and Urban Tanzania

<div><p>Background</p><p>In most countries of Sub-Saharan Africa, control of lymphatic filariasis (LF) is based on annual mass drug administration (MDA) with a combination of ivermectin and albendazole. Treatment coverages are however often suboptimal for programmes to reach the goal of transmission interruption within reasonable time. The present study aimed to identify predictors and barriers to individual drug uptake during MDA implementation by the National LF Elimination Programme in Tanzania.</p><p>Methods</p><p>A questionnaire based cross sectional household survey was carried out in two rural and two urban districts in Lindi and Morogoro regions shortly after the 2011 MDA. 3279 adults (≥15 years) were interviewed about personal characteristics, socio-economic status, MDA drug uptake among themselves and their children, reasons for taking/not taking drugs, and participation in previous MDA activities for LF control.</p><p>Findings</p><p>The overall drug uptake rate was 55.1% (range of 44.5–75.6% between districts). There was no overall major difference between children (54.8%) and adults (55.2%) or between females (54.9%) and males (55.8%), but the role of these and other predictors varied to some extent between study sites. Major overall predictors of drug uptake among the interviewed adults were increasing age and history of previous drug uptake. Being absent from home during drug distribution was the main reason for not taking the drugs (50.2%) followed by clinical contraindications to treatment (10.8%), missing household visits of drug distributors (10.6%), and households not being informed about the distribution (9.0%).</p><p>Conclusion</p><p>Drug uptake relied more on easily modifiable provider-related factors than on individual perceptions and practices in the target population. Limited investments in appropriate timing, dissemination of accurate timing information to recipients and motivation of drug distributors to visit all households (repeatedly when residents are absent) are likely to have considerable potential for increasing drug uptake, in support of successful LF transmission elimination.</p></div

Map showing the location of the study sites in Lindi and Morogoro Region, Tanzania.

<p>Red  =  the two urban study districts; Green  =  the two rural study districts; Yellow  =  remaining parts of the two study regions; DSM  =  Dar es Salaam.</p