Why is it important to identify intimate partner violence during pregnancy?

We will discuss “Intimate partner violence during pregnancy and the risk for adverse infant outcomes: a systematic review and meta-analysis” by Donovan and co-workers from 30 March 2016 for 7 days.

*This paper is now online and will be FREE-TO-VIEW

We are now on LinkedIn too: http://linkd.in/1BVrpad (simply ask to join)!

Start date: 30 March 2016 (the discussion will open for 7 days between 30 March to 6 April 2016)

First hosted discussion session(s) starts at: GMT+1 (British Summer Time) 8pm 

Host: @BlueJCHost

Platforms: Twitter, FacebookLinkedIn and Weibo

BJOG_BlueJC_160x600WebBanner_Mar15_(reoriented)_3The Blue Journal Club is an international journal club on women’s health research based on Twitter (as @BlueJCHost). We start our conversation on the last Wednesday of every month and use the hashtag #BlueJC for our tweets. Simply add this hashtag (“#BlueJC”) to each tweet and we will capture it. Each #BlueJC opens for 7 days with an advertised start time. All BJOG #BlueJC papers also have complementary slide sets suitable for face-to-face journal clubs with your local colleagues. You can access the slide set of this paper here (find the title paper and click on the “discussion point” tab).

The discussion points are attached below (quoted from the published Journal Club guide)

Scenario

A nulliparous woman visits her midwife at 13+0 weeks with her partner. She is a healthy non-smoker. Her dating ultrasound scan was normal. She works as a shop assistant and lives with her partner. This is an unplanned but wanted pregnancy. She reports no concern. You notice small circular burn marks on her forearm, which the woman described as accidental burn by an iron. How would you counsel this woman?

Description of research

Participants Pregnant women
Intervention Women who experienced intimate partner violence (IPV) during pregnancy
Comparison Women who did not experience IPV during pregnancy
Outcomes
  • Preterm birth (PTB): infants born before 37 weeks gestation
  • Low birth weight (LBW): infants born <2500g
  • Small-for-gestational age (SGA): birth weight <10th percentile for a given gestational age
Study design Systematic review and meta-analysis of observational studies
Authors’ conclusion The risks of PTB and LBW were significantly increased in women who experienced IPV.

Discussion Points

  • In your practice, how prevalent is IPV during pregnancy?
  • Which additional factors would you consider when you counsel the woman in the scenario?
  • How was IPV identified in the included studies of this meta-analysis?
  • How was quality of the included studies assessed? (See Table 1 and S1)
  • What are the different factors leading to heterogeneity in a systematic review?
  • How did the authors assess heterogeneity in this systematic review?
  • How did the authors subsequently address the identified heterogeneity of the included studies?
  • Which interventions aimed at preventing IPV have been tested? Are they effective? (See suggested reading)
  • How would the results of this study influence your daily practice?

Suggested reading

  • The Centre for Evidence-based Medicine. Critical appraisal worksheet on systematic review. Available from: http://www.cebm.net/critical-appraisal/.
  • National Institute for Health and Care Excellence. Guideline PH50. Domestic violence and abuse: multi-agency working. February 2014. Available from: https://www.nice.org.uk/guidance/ph50.
  • The Cochrane Collaboration. Part 2 Section 9.5: Heterogeneity. Cochrane Handbook for Systematic Reviews of Interventions. 2011. Version 5.1.0. Available from http://handbook.cochrane.org/.
  • Van Parys A-S, Verhamme A, Temmerman M, Verstraelen H. Intimate Partner Violence and Pregnancy: A Systematic Review of Interventions. Vermund SH, ed. PLoS ONE. 2014;9(1):e85084.

 

For those who want to understand hashtags, this may be a useful guide. For an introduction to #BlueJC, please refer to BJOG 2013;120:657–60. Follow @BlueJCHostthis blog and our Facebook page to receive news about #BlueJC.