Domestic violence and perinatal mental disorders: a systematic review and meta-analysis.

<h4>Background</h4>Domestic violence in the perinatal period is associated with adverse obstetric outcomes, but evidence is limited on its association with perinatal mental disorders. We aimed to estimate the prevalence and odds of having experienced domestic violence among women with an...

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Main Authors: Louise M Howard, Sian Oram, Helen Galley, Kylee Trevillion, Gene Feder
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2013-01-01
Series:PLoS Medicine
Online Access:https://doi.org/10.1371/journal.pmed.1001452
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author Louise M Howard
Sian Oram
Helen Galley
Kylee Trevillion
Gene Feder
author_facet Louise M Howard
Sian Oram
Helen Galley
Kylee Trevillion
Gene Feder
author_sort Louise M Howard
collection DOAJ
description <h4>Background</h4>Domestic violence in the perinatal period is associated with adverse obstetric outcomes, but evidence is limited on its association with perinatal mental disorders. We aimed to estimate the prevalence and odds of having experienced domestic violence among women with antenatal and postnatal mental disorders (depression and anxiety disorders including post-traumatic stress disorder [PTSD], eating disorders, and psychoses).<h4>Methods and findings</h4>We conducted a systematic review and meta-analysis (PROSPERO reference CRD42012002048). Data sources included searches of electronic databases (to 15 February 2013), hand searches, citation tracking, update of a review on victimisation and mental disorder, and expert recommendations. Included studies were peer-reviewed experimental or observational studies that reported on women aged 16 y or older, that assessed the prevalence and/or odds of having experienced domestic violence, and that assessed symptoms of perinatal mental disorder using a validated instrument. Two reviewers screened 1,125 full-text papers, extracted data, and independently appraised study quality. Odds ratios were pooled using meta-analysis. Sixty-seven papers were included. Pooled estimates from longitudinal studies suggest a 3-fold increase in the odds of high levels of depressive symptoms in the postnatal period after having experienced partner violence during pregnancy (odds ratio 3.1, 95% CI 2.7-3.6). Increased odds of having experienced domestic violence among women with high levels of depressive, anxiety, and PTSD symptoms in the antenatal and postnatal periods were consistently reported in cross-sectional studies. No studies were identified on eating disorders or puerperal psychosis. Analyses were limited because of study heterogeneity and lack of data on baseline symptoms, preventing clear findings on causal directionality.<h4>Conclusions</h4>High levels of symptoms of perinatal depression, anxiety, and PTSD are significantly associated with having experienced domestic violence. High-quality evidence is now needed on how maternity and mental health services should address domestic violence and improve health outcomes for women and their infants in the perinatal period.
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spelling doaj-art-04580bbb2b614d88bddf14c97cf48e8d2025-08-20T03:49:59ZengPublic Library of Science (PLoS)PLoS Medicine1549-12771549-16762013-01-01105e100145210.1371/journal.pmed.1001452Domestic violence and perinatal mental disorders: a systematic review and meta-analysis.Louise M HowardSian OramHelen GalleyKylee TrevillionGene Feder<h4>Background</h4>Domestic violence in the perinatal period is associated with adverse obstetric outcomes, but evidence is limited on its association with perinatal mental disorders. We aimed to estimate the prevalence and odds of having experienced domestic violence among women with antenatal and postnatal mental disorders (depression and anxiety disorders including post-traumatic stress disorder [PTSD], eating disorders, and psychoses).<h4>Methods and findings</h4>We conducted a systematic review and meta-analysis (PROSPERO reference CRD42012002048). Data sources included searches of electronic databases (to 15 February 2013), hand searches, citation tracking, update of a review on victimisation and mental disorder, and expert recommendations. Included studies were peer-reviewed experimental or observational studies that reported on women aged 16 y or older, that assessed the prevalence and/or odds of having experienced domestic violence, and that assessed symptoms of perinatal mental disorder using a validated instrument. Two reviewers screened 1,125 full-text papers, extracted data, and independently appraised study quality. Odds ratios were pooled using meta-analysis. Sixty-seven papers were included. Pooled estimates from longitudinal studies suggest a 3-fold increase in the odds of high levels of depressive symptoms in the postnatal period after having experienced partner violence during pregnancy (odds ratio 3.1, 95% CI 2.7-3.6). Increased odds of having experienced domestic violence among women with high levels of depressive, anxiety, and PTSD symptoms in the antenatal and postnatal periods were consistently reported in cross-sectional studies. No studies were identified on eating disorders or puerperal psychosis. Analyses were limited because of study heterogeneity and lack of data on baseline symptoms, preventing clear findings on causal directionality.<h4>Conclusions</h4>High levels of symptoms of perinatal depression, anxiety, and PTSD are significantly associated with having experienced domestic violence. High-quality evidence is now needed on how maternity and mental health services should address domestic violence and improve health outcomes for women and their infants in the perinatal period.https://doi.org/10.1371/journal.pmed.1001452
spellingShingle Louise M Howard
Sian Oram
Helen Galley
Kylee Trevillion
Gene Feder
Domestic violence and perinatal mental disorders: a systematic review and meta-analysis.
PLoS Medicine
title Domestic violence and perinatal mental disorders: a systematic review and meta-analysis.
title_full Domestic violence and perinatal mental disorders: a systematic review and meta-analysis.
title_fullStr Domestic violence and perinatal mental disorders: a systematic review and meta-analysis.
title_full_unstemmed Domestic violence and perinatal mental disorders: a systematic review and meta-analysis.
title_short Domestic violence and perinatal mental disorders: a systematic review and meta-analysis.
title_sort domestic violence and perinatal mental disorders a systematic review and meta analysis
url https://doi.org/10.1371/journal.pmed.1001452
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