Abstract

Background: Intimate partner physical, sexual and psychological abuses and controlling behaviors against pregnant women are common in low-income settings. In Ethiopia, different forms of intimate partner violence (IPV) during pregnancy is highly prevalent and neonatal mortality has been one of the health indicators that did not show significant improvement in the country despite a significant reduction in under-five mortality. We aimed to examine whether exposure to different forms of IPV during pregnancy is associated with neonatal mortality.

Methods: A population based matched case–control study was conducted from January to October 2018 in Eastern Ethiopia. A sample of 103 cases (biological mothers of deceased neonates) and 412 controls (biological mothers of survived neonates) were included in the study. The cases and controls were matched for date of birth, sex of the newborn and place of residences. Conditional logistic regression analysis was performed to assess association between IPV during pregnancy and neonatal mortality, controlling for selected potential confounders.

Results: After controlling for potential confounding factors (pregnancy and obstetric as well socio-demographic characteristics) sexual violence during pregnancy [Adjusted Odds Ratio (AOR) =3.20: 95% CI: 1.09-9.33] and husband/partner controlling behavior (AOR=2.42: 95% CI: 1.06-5.51) were found to be significantly associated with neonatal mortality. Psychological and physical violence during pregnancy did not show significant associations with the neonatal mortality.

Conclusion: Neonatal mortality is strongly associated with intimate partner sexual violence and controlling behaviors during pregnancy. Involving men in maternal health programs is imperative to address issues of violence in pregnancy and promote maternal wellbeing and child health.

Implication for the COVID-19 Pandemic:

Disruption of livelihood due to the pandemic can lead to inability to properly feed children and households and this further exacerbate the risk to IPV for the mothers and infant/neonate loses. Therefore, pregnant women, new mothers and their children should get first-line support in the preparedness and response plans for COVID-19.

Key words: intimate partner violence, partner controlling behavior, pregnancy, women, abuse, neonatal mortality, Ethiopia