Intervenciones para la prevención o la reducción de la violencia doméstica contra la mujer embarazada
Información
- DOI:
- https://doi.org/10.1002/14651858.CD009414.pub3Copiar DOI
- Base de datos:
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- Cochrane Database of Systematic Reviews
- Versión publicada:
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- 12 noviembre 2014see what's new
- Tipo:
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- Intervention
- Etapa:
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- Review
- Grupo Editorial Cochrane:
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Grupo Cochrane de Embarazo y parto
- Copyright:
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- Copyright © 2014 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
Cifras del artículo
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Autores
Contributions of authors
Shayesteh Jahanfar wrote the protocol, conducted an additional search, extracted the data, assessed risk of bias, analysed data, wrote the discussion and abstract and edited the results section. Patricia Janssen commented on the protocol and edited the review. Louise Howard commented on the protocol, extracted data, assessed risk of bias and read and edited the review. Therese Dowswell was involved in data extraction, assessing risk of bias, data analysis and drafting text of the review.
For the 2014 update, Shayesteh Jahanfar and Nancy Medley assessed the new papers for eligibility, extracted data and assessed risk of bias. Shayesteh Jahanfar updated the text of the review. Nancy Medley prepared the 'Summary of findings' table. Louise Howard commented on the updated review.
Sources of support
Internal sources
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No sources of support supplied
External sources
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National Institute for Health Research, UK.
NIHR Programme of centrally‐managed pregnancy and childbirth systematic reviews of priority to the NHS and users of the NHS: 10/4001/02
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UNDP‐UNFPA‐UNICEF‐WHO‐World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Reproductive Health and Research (RHR), World Health Organization, Switzerland.
Declarations of interest
Louise Howard is funded by a National Institute for Health Research Programme Grant for Applied Research on Improving the Healthcare Response to Domestic Violence and is a member of the WHO Guideline Development Group and the NICE/SCIE Guideline Development Group developing guidelines on the preventing and reducing domestic violence.
Acknowledgements
Review authors would like to thank Dr Mark Fitzgerald at Vancouver General Hospital, University of British Columbia for providing information and advice at the protocol stage.
As part of the pre‐publication editorial process, the Jahanfar 2013 review was commented on by three peers (an editor and two referees who are external to the editorial team), a member of the Pregnancy and Childbirth Group's international panel of consumers and the Group's Statistical Adviser.
Therese Dowswell for her contributions to the earlier version of this review (Jahanfar 2013).
Nancy Medley's work was financially supported by the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Reproductive Health and Research (RHR), World Health Organization. The named authors alone are responsible for the views expressed in this publication.
Version history
| Published | Title | Stage | Authors | Version |
| 2014 Nov 12 | Interventions for preventing or reducing domestic violence against pregnant women | Review | Shayesteh Jahanfar, Louise M Howard, Nancy Medley | |
| 2013 Feb 28 | Interventions for preventing or reducing domestic violence against pregnant women | Review | Shayesteh Jahanfar, Patricia A Janssen, Louise M Howard, Therese Dowswell | |
| 2011 Nov 09 | Interventions for preventing or reducing domestic violence against pregnant women | Protocol | Shayesteh Jahanfar, Patricia A Janssen, Louise Howard | |
Keywords
MeSH
Medical Subject Headings (MeSH) Keywords
Medical Subject Headings Check Words
Female; Humans; Pregnancy;
PICO
'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.
Comparison 1 Any intervention to prevent violence (all interventions) versus standard care, Outcome 1 Partner abuse: episodes during pregnancy.
Comparison 1 Any intervention to prevent violence (all interventions) versus standard care, Outcome 2 Partner abuse: episodes during the first 3 months postpartum.
Comparison 1 Any intervention to prevent violence (all interventions) versus standard care, Outcome 3 Partner abuse: abuse score first 3 months postpartum (Conflict Tactics Scale).
Comparison 1 Any intervention to prevent violence (all interventions) versus standard care, Outcome 4 Partner abuse: abuse score in first 3 months postpartum (Conflict Tactics Scale).
Comparison 1 Any intervention to prevent violence (all interventions) versus standard care, Outcome 5 Partner abuse in the first 3 months postpartum (Current abuse score).
Comparison 1 Any intervention to prevent violence (all interventions) versus standard care, Outcome 6 Partner abuse: total episodes at final study assessment (pregnancy and up to 10 weeks postpartum).
Comparison 1 Any intervention to prevent violence (all interventions) versus standard care, Outcome 7 Partner violence at 7‐8 months postpartum.
Comparison 1 Any intervention to prevent violence (all interventions) versus standard care, Outcome 8 Women with depression (after the intervention) during pregnancy.
Comparison 1 Any intervention to prevent violence (all interventions) versus standard care, Outcome 9 Mean Depression Episodes, Psychiatric Status Rating).
Comparison 1 Any intervention to prevent violence (all interventions) versus standard care, Outcome 11 Women with depression up to 3 months postpartum.
Comparison 1 Any intervention to prevent violence (all interventions) versus standard care, Outcome 12 Depression scores up to 3 months postpartum.
Comparison 1 Any intervention to prevent violence (all interventions) versus standard care, Outcome 13 Women with depression up to 1 year postpartum.
Comparison 1 Any intervention to prevent violence (all interventions) versus standard care, Outcome 14 Depression scores up to 1 year postpartum.
Comparison 1 Any intervention to prevent violence (all interventions) versus standard care, Outcome 23 Mean infant birthweight (g).
Comparison 1 Any intervention to prevent violence (all interventions) versus standard care, Outcome 24 Number of low‐birthweight (< 2500 g) babies.
Comparison 1 Any intervention to prevent violence (all interventions) versus standard care, Outcome 25 Preterm labour (before 37 weeks' gestation).
Comparison 1 Any intervention to prevent violence (all interventions) versus standard care, Outcome 26 (Non‐prespecified outcome) Mean gestational age at birth (weeks).
Comparison 1 Any intervention to prevent violence (all interventions) versus standard care, Outcome 27 (Non‐prespecified outcome) Women adopting safety behaviours.
Comparison 1 Any intervention to prevent violence (all interventions) versus standard care, Outcome 28 (Non‐prespecified outcome) stress score in late pregnancy.
Comparison 1 Any intervention to prevent violence (all interventions) versus standard care, Outcome 29 (Non‐prespecified outcome) Did not discuss abuse with care providers.
Comparison 1 Any intervention to prevent violence (all interventions) versus standard care, Outcome 30 (Non‐prespecified outcome) Women reporting any domestic violence 2‐4 years postpartum.
| Any intervention to prevent violence (all interventions) versus standard care for preventing or reducing domestic violence against pregnant women | ||||||
| Patient or population: all pregnant women | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect | No of Participants | Quality of the evidence | Comments | |
| Assumed risk | Corresponding risk | |||||
| Control | Any intervention to prevent violence (all interventions) versus standard care | |||||
| Partner abuse: episodes during pregnancy | Study population | RR 0.5 | 220 | ⊕⊝⊝⊝ | ||
| 182 per 1000 | 91 per 1000 | |||||
| Partner abuse: episodes during the first 3 months postpartum | Study population | RR 0.6 | 271 | ⊕⊝⊝⊝ | ||
| 212 per 1000 | 127 per 1000 | |||||
| Partner abuse: abuse score in the first 3 months postpartum (Conflict Tactics Score*) The CTS is a 19‐item self‐report scale listing behaviours that the respondent’s partner might use in conflicts. Women report the frequency of partner behaviours over the past year on a 7‐point scale where 0 = never and 6 = 20 or more times. | The mean partner abuse: abuse score in the first 3 months postpartum in the intervention groups was | 46 | ⊕⊝⊝⊝ | |||
| Partner abuse in the first 3 months postpartum (Current Abuse Score**) The Current abuse score consists of 2 scales: 1) Abuse Assessment Screen (AAS) and 2) Prenatal Psychosocial Profile (PPP). | The mean partner abuse in the first 3 months postpartum (current abuse score) in the intervention groups was | 191 | ⊕⊝⊝⊝ | |||
| Partner abuse: total episodes at final study assessment (pregnancy and up to 10 weeks postpartum) | Study population | RR 0.62 | 306 | ⊕⊕⊕⊝ | ||
| 378 per 1000 | 234 per 1000 | |||||
| Number of low‐birthweight (< 2500 g) babies | Study population | RR 0.74 | 306 | ⊕⊕⊝⊝ | ||
| 154 per 1000 | 114 per 1000 | |||||
| *The Abuse Assessment Screen (AAS) tool was used to for screening. Respondents who answered ‘yes’ to being physically or emotionally hurt by someone or forced to have sexual activities within the last year were considered abused. These women, who responded "Yes" to AAS tool, were administered the Conflict Tactics Score (CTS). RR: risk ratio; CI: confidence interval | ||||||
| GRADE Working Group grades of evidence | ||||||
| 1 All studies contributing data had design limitations. | ||||||
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 1 Partner abuse: episodes during pregnancy Show forest plot | 1 | 220 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.5 [0.25, 1.02] |
| 2 Partner abuse: episodes during the first 3 months postpartum Show forest plot | 1 | 271 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.60 [0.35, 1.04] |
| 3 Partner abuse: abuse score first 3 months postpartum (Conflict Tactics Scale) Show forest plot | 1 | 46 | Mean Difference (IV, Fixed, 95% CI) | 4.20 [‐10.74, 19.14] |
| 4 Partner abuse: abuse score in first 3 months postpartum (Conflict Tactics Scale) Show forest plot | 1 | Mean Difference (IV, Fixed, 95% CI) | Subtotals only | |
| 4.1 Psychological abuse | 1 | 106 | Mean Difference (IV, Fixed, 95% CI) | ‐0.81 [‐1.45, ‐0.17] |
| 4.2 Minor physical violence score | 1 | 106 | Mean Difference (IV, Fixed, 95% CI) | ‐0.46 [‐0.82, ‐0.10] |
| 4.3 Severe physical violence score | 1 | 106 | Mean Difference (IV, Fixed, 95% CI) | 0.08 [‐0.28, 0.44] |
| 4.4 Sexual abuse score | 1 | 106 | Mean Difference (IV, Fixed, 95% CI) | ‐0.09 [‐0.24, 0.06] |
| 5 Partner abuse in the first 3 months postpartum (Current abuse score) Show forest plot | 1 | 191 | Mean Difference (IV, Fixed, 95% CI) | ‐0.12 [‐0.31, 0.07] |
| 6 Partner abuse: total episodes at final study assessment (pregnancy and up to 10 weeks postpartum) Show forest plot | 1 | 306 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.62 [0.43, 0.88] |
| 7 Partner violence at 7‐8 months postpartum Show forest plot | 1 | 181 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.53 [0.23, 1.21] |
| 8 Women with depression (after the intervention) during pregnancy Show forest plot | 1 | 46 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.42 [0.04, 4.31] |
| 9 Mean Depression Episodes, Psychiatric Status Rating) Show forest plot | 1 | 46 | Mean Difference (IV, Fixed, 95% CI) | ‐0.46 [‐0.97, 0.05] |
| 10 Depression scores (after the intervention) during pregnancy | 0 | 0 | Mean Difference (IV, Fixed, 95% CI) | 0.0 [0.0, 0.0] |
| 11 Women with depression up to 3 months postpartum Show forest plot | 2 | Risk Ratio (M‐H, Fixed, 95% CI) | Subtotals only | |
| 11.1 Empowerment training | 1 | 106 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.39 [0.20, 0.75] |
| 11.2 Psychological therapy intervention | 1 | 46 | Risk Ratio (M‐H, Fixed, 95% CI) | 1.40 [0.38, 5.18] |
| 12 Depression scores up to 3 months postpartum Show forest plot | 1 | 46 | Mean Difference (IV, Fixed, 95% CI) | ‐1.88 [‐5.24, 1.48] |
| 13 Women with depression up to 1 year postpartum Show forest plot | 1 | 182 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.85 [0.37, 1.98] |
| 14 Depression scores up to 1 year postpartum Show forest plot | 1 | 182 | Mean Difference (IV, Fixed, 95% CI) | ‐0.65 [‐2.41, 1.11] |
| 15 Apgar score less than 7 at 1 minute | 0 | 0 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.0 [0.0, 0.0] |
| 16 Apgar score less than 7 at 5 minutes | 0 | 0 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.0 [0.0, 0.0] |
| 17 Stillbirth | 0 | 0 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.0 [0.0, 0.0] |
| 18 Neonatal death | 0 | 0 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.0 [0.0, 0.0] |
| 19 Miscarriage (up to 20 weeks) | 0 | 0 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.0 [0.0, 0.0] |
| 20 Maternal mortality | 0 | 0 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.0 [0.0, 0.0] |
| 21 Antepartum haemorrhage | 0 | 0 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.0 [0.0, 0.0] |
| 22 Placental abruption | 0 | 0 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.0 [0.0, 0.0] |
| 23 Mean infant birthweight (g) Show forest plot | 1 | 306 | Mean Difference (IV, Fixed, 95% CI) | 41.0 [‐106.19, 188.19] |
| 24 Number of low‐birthweight (< 2500 g) babies Show forest plot | 1 | 306 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.74 [0.41, 1.32] |
| 25 Preterm labour (before 37 weeks' gestation) Show forest plot | 1 | 306 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.69 [0.40, 1.20] |
| 26 (Non‐prespecified outcome) Mean gestational age at birth (weeks) Show forest plot | 1 | 306 | Mean Difference (IV, Fixed, 95% CI) | 1.40 [0.33, 2.47] |
| 27 (Non‐prespecified outcome) Women adopting safety behaviours Show forest plot | 1 | 204 | Risk Ratio (M‐H, Fixed, 95% CI) | 2.6 [1.41, 4.79] |
| 28 (Non‐prespecified outcome) stress score in late pregnancy Show forest plot | 1 | 191 | Mean Difference (IV, Fixed, 95% CI) | ‐2.06 [‐3.34, ‐0.78] |
| 29 (Non‐prespecified outcome) Did not discuss abuse with care providers Show forest plot | 1 | 46 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.17 [0.04, 0.66] |
| 30 (Non‐prespecified outcome) Women reporting any domestic violence 2‐4 years postpartum Show forest plot | 1 | 735 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.81 [0.60, 1.08] |
