title: Interventions for preventing or reducing domestic violence against pregnant women.
abstract: BACKGROUND
  Domestic violence during pregnancy is a major public health concern. This preventable risk factor threatens both the mother and baby. Routine perinatal care visits offer opportunities for healthcare professionals to screen and refer abused women for effective interventions. It is, however, not clear which interventions best serve mothers during pregnancy and postpartum to ensure their safety.
  
  
  OBJECTIVE
  To examine the effectiveness and safety of interventions in preventing or reducing domestic violence against pregnant women.
  
  
  METHODS
  We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (19 June 2012), scanned bibliographies of published studies and corresponded with investigators.
  
  
  METHODS
  We included randomised controlled trials (RCTs) including cluster-randomised trials, and quasi-randomised controlled trials (e.g. where there was alternate allocation) investigating the effect of interventions in preventing or reducing domestic violence during pregnancy.
  
  
  METHODS
  Two review authors independently assessed trial quality and extracted data.
  
  
  RESULTS
  We included nine trials with a total of 2391 women; however, for most outcomes very few studies contributed data and results were predominantly based on findings from single studies. There was evidence from one study that the total number of women reporting episodes of partner violence during pregnancy, and in the postpartum period was reduced for women receiving a psychological therapy intervention (risk ratio (RR) 0.62, 95% confidence interval (CI) 0.48 to 0.88). There were few statistically significant differences between intervention and control groups for depression during pregnancy and the postnatal period. Only one study reported findings for neonatal outcomes such as preterm delivery and birthweight, and there were no clinically significant differences between groups. None of the studies reported results for other secondary outcomes: Apgar score less than seven at one minute and five minutes, stillbirth, neonatal death, miscarriage, maternal mortality, antepartum haemorrhage, and placental abruption.
  
  
  CONCLUSIONS
  There is insufficient evidence to assess the effectiveness of interventions for domestic violence on pregnancy outcomes. There is a need for high-quality, RCTs with adequate statistical power to determine whether intervention programs prevent or reduce domestic violence episodes during pregnancy, or have any effect on maternal and neonatal mortality and morbidity outcomes.
authors: Department of PublicHealth, School of Population and PublicHealth,University of British Columbia, Vancouver, Canada. jahanfar2000@yahoo.com
authors: Shayesteh
authors: S
authors: Jahanfar
authors: Patricia A
authors: PA
authors: Janssen
authors: Louise M
authors: LM
authors: Howard
authors: Therese
authors: T
authors: Dowswell
mesh_terms: D017579:Domestic Violence / Q000517:prevention & control* / Q000523:psychology; D005260:Female; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D037841:Pregnant People / Q000523:psychology; D016032:Randomized Controlled Trials as Topic; D012449:Safety