Breastfeeding avoidance following psychological intimate partner violence during pregnancy: a cohort study and multivariate analysis. (24th January 2019)

• Record Type: Journal Article
• Authors: Martin‐de‐las‐Heras, S; Velasco, C; Luna‐del‐Castillo, JD; Khan, KS
• Is Part Of: BJOG. Volume 126:Number 6(2019)
• Page Start: 778
• Page End: 783
• Publication Date: 2019-01-24
• Subjects: Breastfeeding -- gender‐based violence -- intimate partner violence -- maternal outcomes -- pregnancy -- risk factors; Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1111/1471-0528.15592
• Languages: English
• ISSNs: 1470-0328

Abstract

Abstract : Objective: To evaluate if the experience of psychological intimate partner violence (IPV) adversely affects breastfeeding rates. Design: A cohort study. Setting: Maternities in 15 public hospitals, drawn using cluster sampling of obstetric services in Andalusia, Spain. Population: A total of 779 consecutive mothers receiving antenatal care including ultrasound and giving birth during February–June 2010. Methods: Trained midwives gathered IPV data using the Index of Spouse Abuse validated in the Spanish language (score ranges: 0–100, higher scores reflect more severe IPV; cut‐off: psychological IPV = 25). Sociodemographic data including lack of kin support, and obstetric and neonatal outcomes were collected. Multivariate logistic regression estimated adjusted odds ratios (aOR), with 95% confidence intervals (CI), of the relationship between psychological IPV and breastfeeding, controlling for sociodemographic characteristics and obstetric complications. Main outcome measure: Breastfeeding avoidance defined as lack of breastfeeding or pumping of breast milk to feed the new baby in the immediate post‐partum period. Results: Response rate was 92.2%. A total of 70% ( n = 545) of women initiated breastfeeding. Psychological IPV, reported by 21.0% ( n = 151), increased the odds of breastfeeding avoidance (aOR = 2.0; 95% CI = 1.2–3.3) adjusting for the presence of obstetric complications (aOR = 1.6; 95% CI = 1.0–2.4). Conclusions: Mothers with psychological IPV avoid breastfeeding. Clinicians should be aware of the risks to infant arising from this deficiency due to IPV in pregnancy. Tweetable abstract: Psychological intimate partner violence, reported by one in five mothers in this study, on average doubles the avoidance of breastfeeding. Tweetable abstract: Psychological intimate partner violence, reported by one in five mothers in this study, on average doubles the avoidance of breastfeeding.