Nelly Lam

Prevalence, Types, and Pattern of Intimate Partner Violence Among Pregnant Women in Lima, Peru

This study assesses the prevalence, types, and pattern of intimate partner violence (IPV) during lifetime and current pregnancy for 2,392 women in Lima, Peru. The reported lifetime prevalence of any IPV (physical, sexual, or emotional) is 45.1%. For women who experienced abuse, the prevalence of lifetime physical, emotional, and sexual IPV is 34.2%, 28.4%, and 8.7%, respectively. Older (≥ 30 years), unmarried, employed, and economically disadvantaged women and those with little education are more likely to experience lifetime and pregnancy IPV. Efforts at universal antepartum IPV screening and appropriate interventions are needed to reduce the burden of violence experienced by pregnant women.

Intimate partner violence and risk for depression among postpartum women in Lima, Peru

A cross-sectional study of 2,317 women who delivered at Instituto Nacional Materno Perinatal, Lima, Peru, was carried out to evaluate risk of depression in relation to maternal experience with intimate partner violence (IPV) before and during pregnancy. Depression severity was assessed using the Patient Health Questionnaire Depression Subset (PHQ-9). The prevalence of IPV during lifetime and pregnancy was 44% and 21%, respectively. Adjusted odds ratios and 95% confidence intervals for each level of depression severity associated with history of IPV during pregnancy were: mild 1.4 (1.9–2.3); moderate 2.9 (1.8–4.5); moderately severe 5.5 (3.4–9.2); and severe 9.9 (5.1–19.9). A positive gradient was observed for severity of depression and IPV during pregnancy (trend p < 0.001). Postpartum women who experienced IPV during pregnancy had higher levels of depression severity than did nonabused women.

Headaches and Migraines Are Associated With an Increased Risk of Preeclampsia in Peruvian Women

BACKGROUND Migraine, a common chronic-intermittent disorder of idiopathic origin characterized by severe debilitating headaches and autonomic nervous system dysfunction, and preeclampsia, a hypertensive disorder of pregnancy, share many common epidemiological and pathophysiological characteristics. Both conditions are associated with higher subsequent risk of ischemic stroke. Moreover, endothelial dysfunction, platelet activation, hyper-coagulation, and inflammation are common to both disorders. We assessed the risk for preeclampsia in relation to the maternal history of migraine before and during pregnancy in Peruvian women. METHODS Cases consisted of 339 women with preeclampsia, and controls were 337 normotensive women. During in-person interviews conducted at delivery, women were asked whether they had physician-diagnosed migraines, and they were asked questions that allowed for headaches and migraines to be classified according to criteria established by the International Headache Society (IHS). Logistic regression procedures were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS A history of any headache before or during pregnancy was associated with a 2.4-fold increased risk for preeclampsia (OR = 2.4; 95% CI 1.7-3.3). Women classified as having migraines that began prior to pregnancy had a 3.5-fold increased risk for preeclampsia (95% CI 1.9-6.4) as compared with those who reported no migraines. Women with migraines during pregnancy had a fourfold increased risk of preeclampsia (OR = 4.0, 95% CI 1.9-8.2) compared with non-migraineurs. CONCLUSIONS Our findings are consistent with previous reports and we have extended them to the Peruvian population. Prospective cohort studies, however, are needed to more rigorously evaluate the extent to which migraines and/or its treatments are associated with the occurrence of preeclampsia.

Correlates of Violent Response Among Peruvian Women Abused by an Intimate Partner

The authors sought to identify correlates of violent response among women exposed to intimate partner violence (IPV) in Lima, Peru. A structured questionnaire was used to collect information on exposure to IPV and womens physical violent reaction towards their abuser. Women who were sexually abused by their partners, as compared with women who experienced emotional abuse only, were more than twice as likely to respond in a violent manner to the abuse (OR = 2.32, 95% CI = 1.14-4.74). Similarly, women who reported being physically abused, were 4 times as likely than those who experienced emotional abuse only to retaliate in a physically violent manner (OR = 4.04, 95% CI = 2.68-6.11). Womens educational status, history of witnessing parental violence as a child, and type of IPV are significantly associated with womens violent response. Community support networks and culturally appropriate intervention programs designed to prevent and mitigate the impact of IPV are needed.