Associations between intimate partner violence and adverse birth outcomes during pregnancy: a systematic review and meta-analysis

BACKGROUND: Intimate partner violence (IPV) has been associated with an elevated risk of multiple adverse birth outcomes, yet little is known about how specific IPV influences adverse birth outcomes. The aim of this study was to examine the association between IPV during pregnancy and adverse birth outcomes (i.e., preterm birth, low birth weight, and stillbirth). METHODS: Systematic searches were conducted using four databases: EMBASE, Web of Science, PubMed, and CINAHL for observational studies published from 1 January 2011 to 31 August 2021. Two reviewers independently carried out the literature search, study selection, data extraction, assessment of the study, and risk of bias assessment; disagreements were resolved by a third reviewer. A random-effect model was used to calculate the odds ratio (OR) with a 95% confidence interval (CI) for preterm birth, low birth weight, and stillbirth. I(2) statistic accompanied by chi-square p-value was used to assess heterogeneity, and funnel plot and Peter's test were used to assess publication bias. RESULTS: In total, 23 studies met the inclusion criterion. IPV was associated with preterm birth (OR = 1.84; 95% CI: 1.37–2.49; I(2) = 88%), low birth weight (OR = 2.73; 95% CI: 1.66–4.48; I(2) = 95%), and stillbirth (OR = 1.74; 95% CI: 0.86–3.54; I(2) = 64%). We attained comparable results among all specific IPV including physical, sexual, emotional, and mixed. CONCLUSION: Intimate partner violence and specific IPV during pregnancy were significantly associated with adverse birth outcomes, especially for physical IPV. An urgent need for greater action to prevent or intervene in IPV during pregnancy is warranted. SYSTEMATIC REVIEW REGISTRATION: CRD42021282936, https://www.crd.york.ac.uk/prospero/.