The impact of psychological abuse by an intimate partner on the mental health of pregnant women

Authors: Tiwari; Chan^{1, 2}; Fong³; Leung⁴; Brownridge⁵; Lam^{4, 6}; Wong⁷; Chau⁸; Cheung⁹; Ho¹⁰

Source: BJOG: An International Journal of Obstetrics & Gynaecology, Volume 115, Number 3, February 2008 , pp. 377-384(8)

Publisher: Wiley-Blackwell

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Abstract:

Objective

The objective of this first population-based study in Hong Kong was to assess the impact of psychological abuse by an intimate partner on the mental health of pregnant women. Design

Survey. Setting

Antenatal clinics in seven public hospitals in Hong Kong. Population

Three thousand two hundred and forty-five pregnant women. Methods

The Abuse Assessment Screen (AAS) and demographic questionnaires were administered face-to-face at 32-36 weeks of gestation. At 1 week postpartum, the AAS, Edinburgh Postnatal Depression Scale and SF-12 Health Survey were administered by telephone. Main outcome measures

Intimate partner violence, postnatal depression and health-related quality of life. Results

Two hundred and ninety six (9.1%) of the participants reported abuse by an intimate partner in the past year. Of those abused, 216 (73%) reported psychological abuse only and 80 (27%) reported physical and/or sexual abuse. Forty six (57.5%) in the physical and/or sexual abuse group also reported psychological abuse. Women in the psychological abuse only group had a higher risk of postnatal depression compared with nonabused women (adjusted OR: 1.84, 95% CI: 1.12-3.02). They were also at a higher risk of thinking about harming themselves (adjusted OR: 3.50, 95% CI: 1.49-8.20) and had significantly poorer mental health-related quality of life (P < 0.001). The higher risks of postnatal depression and thinking of harming themselves were not observed in the physical and/or sexual abuse group although significantly poorer mental health-related quality of life (P < 0.001) was observed. Conclusions

Psychological abuse by an intimate partner against pregnant women has a negative impact on their mental health postdelivery. Furthermore, psychological abuse in the absence of physical and/or sexual abuse can have a detrimental effect on the mental health of abused women. The findings underscore the importance of screening pregnant women for abuse by an intimate partner and the need for developing, implementing and evaluating interventions to address psychological abuse.

Keywords: Intimate partner violence; pregnancy; psychological abuse

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1471-0528.2007.01593.x

Affiliations: 1: Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China 2: Department of Obstetrics and Gynaecology, United Christian Hospital, Hong Kong, China 3: Department of Nursing Studies, LKS Faculty of Medicine 4: Department of Obstetrics and Gynaecology, Kwong Wah Hospital, Hong Kong, China 5: Department of Family Social Sciences, Arthur V. Mauro Centre for Peace and Justice, University of Manitoba, Winnipeg, Canada 6: Department of Obstetrics and Gynaecology, Princess Margaret Hospital, Hong Kong, China 7: Department of Obstetrics and Gynaecology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China 8: Department of Obstetrics and Gynaecology, Queen Elizabeth Hospital, Hong Kong, China 9: Department of Obstetrics and Gynaecology, Tuen Mun Hospital, Hong Kong, China 10: Department of Obstetrics and Gynaecology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China

Publication date: 2008-02-01

The impact of psychological abuse by an intimate partner on the mental health of pregnant women

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