title: High-frequency intimate partner violence during pregnancy, postnatal depression and suicidal tendencies in Harare, Zimbabwe.
abstract: BACKGROUND
  Intimate partner violence (IPV) is a common form of violence experienced by pregnant women and is believed to have adverse mental health effects postnatally. This study investigated the association of postnatal depression (PND) and suicidal ideation with emotional, physical and sexual IPV experienced by women during pregnancy.
  
  
  METHODS
  Data were collected from 842 women interviewed postnatally in six postnatal clinics in Harare, Zimbabwe. We used the World Health Organization versions of IPV and Centre for Epidemiological Studies - Depression Scale measures to assess IPV and PND respectively. We derived a violence severity variable and combined forms of IPV variables from IPV questions. Logistic regression was used to analyse data whilst controlling for past mental health and IPV experiences.
  
  
  RESULTS
  One in five women [21.4% (95% CI 18.6-24.2)] met the diagnostic criteria for PND symptomatology whilst 21.6% (95% CI 18.8-24.4) reported postpartum suicide thoughts and 4% (95% CI 2.7-5.4) reported suicide attempts. Two thirds (65.4%) reported any form of IPV. Although individual forms of severe IPV were associated with PND, stronger associations were found between PND and severe emotional IPV or severe combined forms of IPV. Suicidal ideation was associated with emotional IPV. Other forms of IPV, except when combined with emotional IPV, were not individually associated with suicidal ideation.
  
  
  CONCLUSIONS
  Emotional IPV during pregnancy negatively affects women's mental health in the postnatal period. Clinicians and researchers should include it in their conceptualisation of violence and health. Further research must look at possible indirect relationships between sexual and physical IPV on mental health.
authors.affiliation: Gender and Health Research Unit, Medical Research Council, 7505 Tygerberg, South Africa; School of Public Health, University of the Western Cape, 7535 Bellville, South Africa; Foundation for Professional Development, 0184 Pretoria, South Africa. Electronic address: shamuts@yahoo.com.
authors.forename: Simukai
authors.initials: S
authors.lastname: Shamu
authors.affiliation: School of Public Health, University of the Western Cape, 7535 Bellville, South Africa; University of Montreal Hospital Research Centre, Montreal, QC, Canada H2X 0A9.
authors.forename: Christina
authors.initials: C
authors.lastname: Zarowsky
authors.affiliation: International Centre for Reproductive Health, Ghent University, 9000 Ghent, Belgium.
authors.forename: Kristien
authors.initials: K
authors.lastname: Roelens
authors.affiliation: International Centre for Reproductive Health, Ghent University, 9000 Ghent, Belgium.
authors.forename: Marleen
authors.initials: M
authors.lastname: Temmerman
authors.affiliation: Gender and Health Research Unit, Medical Research Council, 7505 Tygerberg, South Africa; School of Public Health, University of the Western Cape, 7535 Bellville, South Africa.
authors.forename: Naeemah
authors.initials: N
authors.lastname: Abrahams
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D019052:Depression, Postpartum / Q000453:epidemiology*; D005260:Female; D006801:Humans; D000066511:Intimate Partner Violence / Q000706:statistics & numerical data*; D016015:Logistic Models; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D012307:Risk Factors; D012742:Sex Offenses / Q000706:statistics & numerical data*; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D015030:Zimbabwe / Q000453:epidemiology
keywords: Intimate partner violence; Postnatal depression; Postnatal suicidal ideation; Zimbabwe