Risk factors and health profiles of recent migrant women who experienced violence associated with pregnancy.
BACKGROUND
Violence associated with pregnancy is a major public health concern, but little is known about it in recent migrant women. This study looked at (1) risk factors for violence associated with pregnancy among newly arrived migrant women in Canada and (2) if those who experienced violence associated with pregnancy had a different health profile or use of healthcare services for themselves or their infants during pregnancy and up to 4 months postpartum compared to other childbearing migrant women.


METHODS
Pregnant migrant women in Canada <5 years were recruited in 12 hospitals in 3 large cities between 2006 and 2009 and followed to 4 months postpartum. Data were collected on maternal background, migration history, violence associated with pregnancy, maternal and infant physical and mental health, and services used.


RESULTS
Of a total of 774 pregnant migrant women, 59 (7.6%) women reported violence associated with pregnancy. Migrant women who experienced violence, compared to those who did not, were at increased risk of violence if they lived without a partner, were asylum seekers, migrated <2 years ago, or had less than high school education. Women who reported violence were less likely to have up-to-date vaccinations, take folic acid before pregnancy, more likely to commence prenatal care after 3 months gestation and to not use contraceptives after birth. They were also more likely to have a history of miscarriage and report more postpartum pain and increased bleeding. They were also more likely to have inadequate social support and report more depression, anxiety, somatization, and posttraumatic stress disorder (PTSD) on standardized tests. No differences were found in the health status of the infants of women who experienced violence compared to those who did not.


CONCLUSIONS
Clinicians should sensitively ask recent migrant women (asylum seekers, refugees, and nonrefugee immigrants) about violence associated with pregnancy and appropriately assess, treat, and refer them.
University Health Network and University of Toronto, Ontario, Canada. donna.stewart@uhn.ca
Donna E
DE
Stewart
Anita J
AJ
Gagnon
Lisa A
LA
Merry
Cindy-Lee
CL
Dennis
D000328:Adult; D000704:Analysis of Variance; D002170:Canada / Q000208:ethnology; D016001:Confidence Intervals; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005260:Female; D015438:Health Behavior / Q000208:ethnology*; D006297:Health Services Accessibility; D006304:Health Status; D006801:Humans; D010342:Patient Acceptance of Health Care / Q000208:ethnology; D049590:Postpartum Period; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000208:ethnology; D018570:Risk Assessment; D012307:Risk Factors; D012944:Social Support; D012959:Socioeconomic Factors; D013179:Spouse Abuse / Q000208:ethnology* / Q000523:psychology / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D055815:Young Adult