Impact of social violence and childhood adversities on pregnancy outcomes: a longitudinal study in Tunisia
| Autor: | Kamel Ben Salem, Imen Mlouki, Sana El Mhamdi, Andrine Lemieux, Arwa Ben Salah, Ines Bouanene, Mustafa al'Absi, Ines Amor |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Adult
medicine.medical_specialty Tunisia Birth weight 030231 tropical medicine Poison control Violence Suicide prevention 03 medical and health sciences Young Adult 0302 clinical medicine Adverse Childhood Experiences Pregnancy Risk Factors Medicine Humans 030212 general & internal medicine Longitudinal Studies Reproductive health business.industry Depression Health Policy Public health Public Health Environmental and Occupational Health Pregnancy Outcome Articles medicine.disease Low birth weight Premature birth Female medicine.symptom business Demography |
| Zdroj: | Journal of Global Health |
| ISSN: | 2047-2986 2047-2978 |
| Popis: | Background Accumulating research suggests that exposure to intra-familial adversities are significant risk factors for adverse pregnancy outcomes. However, the relationship between social violence (peer violence, witnessing community violence and exposure to collective violence) and pregnancy outcomes has not been extensively investigated. Our study aims to examine the association between social Adverse Childhood Experiences (ACEs) and pregnancy outcomes and to explore the role of depression during pregnancy as a mediator of this association. Methods We performed a prospective follow-up study of pregnant women in five Primary Health care Centers (PHC) in the region of Monastir (Tunisia) from September 2015 to August 2016. Enrolled women were followed during the second trimester, third trimester of pregnancy and during the postnatal period. Exposure to violence was assessed retrospectively using the validated Arabic version of the World Health Organization (WHO) ACE questionnaire. The Self Reporting Questionnaire 20-Item (SRQ-20) was used as a screening tool for depression during pregnancy. Results We recruited and followed a total of 593 women during the study period. Witnessing community violence was the most frequently reported social ACE among pregnant women (237; 40%), followed by peer violence (233; 39.3%). After adjustment for high risk pregnancies, environmental tobacco smoke, and intra-familial ACEs, the risk of premature birth was significantly associated with exposure to collective violence (P |
| Databáze: | OpenAIRE |
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