Thesis (MSc)--Stellenbosch University, 2003. / ENGLISH ABSTRACT: Introduction
Worldwide, up to 25% of women are assaulted during pregnancy, with estimates
varying between populations. Violence has been associated with adverse
pregnancy outcome, including preterm birth, abruptio placentae and low birth
weight. Among the Coloured population of the Western Cape the incidence of
spontaneous preterm birth is 20%, compared to the global figure of 10%.
Overall, the rate of preterm labour has not dropped over the past 40 years and
no clearer answer as to a specific cause has been found.
The objective of this study was to determine whether patients who deliver
preterm experience more domestic violence than those who deliver at term.
Methods
Two groups of patients were assessed. Firstly, patients who spontaneously
delivered between 24 and 33 weeks (24wOd - 33w6d), who were admitted for
suppression of active labour after 24 weeks, or who experienced placental
abruption before 34 weeks, were screened for domestic violence using the
"Abuse Assessment Screen". A second group of women, attending a local
Midwife Obstetric Unit with uncomplicated pregnancies, completed the same
questionnaire. The questionnaires were all administered by the same person
(J.S.) after written informed consent was given.
Results
A total of 229 patients were interviewed, 99 in the low risk (LR) and 130 in the
preterm labour (PTL) group, which included 23 women with abruptio placentae.
The PTL group experienced significantly more violence throughout their lives
than the LR group (59.7% vs. 40.4%, p = 0.038). Experiences of violence within the last year or during the pregnancy did not reach statistical significance
between the two groups, although the numbers were higher for the PTL group.
The PTL group smoked significantly more cigarettes per day (p = 0.009), used
more alcohol (p < 0.001) and had a higher incidence of syphilis than the LR
group (p = 0.005). These differences remained the same when the abruptio's
were analyzed as a separate group.
Conclusions: Women who delivered preterm did experience more violence at
some point in their lives and were also more likely to engage in high-risk
behaviour. Violence alone does not seem to cause PTL directly, but is part of a
low socioeconomic lifestyle. The fact that the alcohol use is so high among these
women is a problem that needs to be addressed, but once again, it is possibly
the result of deeper social problems. The need for education on values and
respect, family planning use and low risk sexual behaviour is once again
challenged. / AFRIKAANSE OPSOMMING: GEWELD TEEN VROUE -IMPAK OP REPRODUKTIEWE GESONDHEID EN
UITKOMS VAN SWANGERSKAP
Inleiding
Daar word beraam dat tot 25% van alle swanger vroue aangerand word, maar
die insidensie wissel tussen verskillende populasies. Ervarings van geweld kan
'n direkte of indirekte oorsaak wees van swak verloskundige uitkoms wat
voortydse kraam, abruptio placentae en lae geboortegewig insluit. In die Wes-
Kaap, onder die Kleurlingbevolking, is die insidensie van voortydse kraam 20%,
wat swak vergelyk met die wêreldwye insidensie van 10%. Gedurende die laaste
40 jaar het die voorkoms van voortydse kraam nie verminder nie en geen
deurbrake is gemaak t.o.v die oorsaak van die probleem nie. Die doel van
hierdie studie was om te bepaal of vroue wat prematuur verlos moontlik meer
geweld ervaar as vroue wat op normale swangerskapsduur verlos.
Metodes
Twee groepe vroue is bestudeer. Die eerste groep het vroue ingesluit wat
spontaan verlos het tussen 24 en 33 weke (24wOd - 33w6d) of vroue wat na 24
weke swangerskapsduur toegelaat is vir onderdrukking van kraam. Vroue met
plasentale loslating (abruptio placentae) voor 34 weke, sonder onderliggende
hipertensiewe toestande, was ook ingesluit in die groep. Daar is m.b.v. 'n
vraelys ("Abuse Assessment Screen") bepaal watter van die vroue gesinsgeweld
ervaar het. Die tweede groep het vroue ingesluit met ongekompliseerde
swangerskappe en wat by 'n nabygeleë kliniek voorgeboortesorg ontvang het.
Hulle is ook gevra om die vraelys te voltooi en is opgevolg om die uitkoms van
hulle swangerskappe te noteer. Die vraelyste is almal deur een persoon (J.S.)
aan die vroue voorgelê nadat hulle ingeligte, skriftelike toestemming gegee het. Resultate
'n Totaal van 229 vroue was ingesluit, 99 in die lae risiko (LR) groep en 130 in
die voortydse kraam (VK) groep, waarvan 23 abruptio placentae gehad het. In
vergelyking met die LR groep, het die VK groep het betekenisvol meer geweld in
hulle leeftyd ervaar (59.7% teenoor 40.4%, p = 0.038). Geweld wat tydens die
afgelope jaar of tydens die swangerskap ervaar is, het nie betekenisvol verskil
tussen die twee groepe nie, alhoewel die getalle hoër was vir die VK groep. Die
VK groep het betekenisvol meer sigarette per dag gerook (p = 0.009), meer
alkohol gebruik (p < 0.001) en het 'n hoër insidensie van sifilis gehad as die LR
groep (p = 0.005). Hierdie verskille was steeds beduidend nadat dié met
abruptio placentae as 'n aparte groep geanaliseer is.
Gevolgtrekking
Die vroue wat prematuur verlos het, het meer emosionele en fisiese geweld in
hulle leeftyd ervaar en is meer geneig om 'n ongesonde leefstyl te handhaaf.
Geweld blyk nie 'n direkte oorsaak van voortydse kraam te wees nie, maar gaan
gepaard met 'n lae sosio-ekonomiese lewensstyl. Die hoë insidensie van
alkoholgebruik onder swanger vroue is 'n probleem wat aangespreek moet word,
maar dit is waarskynlik die manifestasie van dieper emosionele probleme.
Opvoeding in terme van waardes en respek, gesinsbeplanning en veilige
seksuele gedrag is gevolglik 'n noodsaaklikheid.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:sun/oai:scholar.sun.ac.za:10019.1/53713 |
| Date | 03 1900 |
| Creators | Schoeman, Jeanne |
| Contributors | Du Plessis, S. S., Odendaal, H. J., Stellenbosch University. Faculty of Medicine & Health Sciences. Dept. of Interdisciplinary Health Sciences. |
| Publisher | Stellenbosch : Stellenbosch University |
| Source Sets | South African National ETD Portal |
| Language | en_ZA |
| Detected Language | Unknown |
| Type | Thesis |
| Format | 174 p. |
| Rights | Stellenbosch University |
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