Inter-partner violence during pregnancy, maternal mental health and birth outcomes in Vietnam: A systematic review

Introduction: Intimate partner violence (IPV) is common worldwide and associated with maternal mental disorders and adverse child health outcomes. Research in this field in Vietnam is still nascent, although some substantial studies have emerged in recent years. The objective of this review was to estimate the prevalence of IPV during pregnancy in Vietnam and examine its impact upon women and children at an early age. Methods: We searched seven bibliographic databases (from 1970 to 2018), browsed grey literature sources, and consulted experts. Two review authors independently extracted data and assessed risk of bias with using the Newcastle - Ottawa Quality Assessment Tool for non-randomized studies. A meta-analysis was conducted using the Mantel-Haenszel fixed-effect approach to estimate pooled effect (odds ratio) of Prenatal IPV (P-IPV) on maternal Common Mental Disorder (CMD). Results: The selection process produced eight eligible studies of 4598 participants. Six studies were pooled. The estimated proportions of IPV during pregnancy ranged from 5.9% to 32.5% depending on the form of IPV. P-IPV is strongly associated with greater risk of both mental disorders and adverse birth outcomes (preterm labor and low-birth-weight). The meta-analysis revealed that women exposed to P-IPV have a 4-fold increased risk for prenatal CMD compared to non-abused peers (OR = 3.69, 95% CI (2.51-5.42), I-2 = 36%). Women exposed to physical P-IPV had five-fold increased odds of premature labour, OR = 5.5, 95% CI (2.1-14.1) and almost sixfold increased odds of having low-birth-weight neonates, OR = 5.7, 95% CI (2.2-14.9). Discussion: To improve mother and child well-being in Vietnam, multifaceted health policies should include routine screening for IPV and mental disorders in the antenatal care system. Taken together, the evidence supports calls for national programs in Vietnam to eliminate gender inequality and promote awareness of the serious harms caused by WV.