Violence, pregnancy and birth outcome in Appalachia

Timothy Dye · Nancy J. Tolliver · Richard V. Lee · Catherine J. Kenney

98 citations0/0 files storedPaediatric and Perinatal Epidemiology

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Intimate Partner and Family Violence Maternal and Perinatal Health Interventions Prenatal Substance Exposure Effects

Abstract

Few studies have followed pregnant women prospectively to examine the impact of violence on birth outcome. We included such an assessment in a prospective study of pregnancy among low-income women. Nurses and social workers interviewed pregnant women (n = 364) and asked if they had been the object of violence since they became pregnant. These prenatal interviews were linked with information from perinatal records and with birth and death information. In total, 15.9% of women in the study indicated they had been abused since they became pregnant. Abused women were more likely to be teenagers and to have partners who were teenagers. Abused women were more likely to be primiparous, to smoke during pregnancy and to have physical problems related to stress. Women battered during pregnancy were more likely to suffer fetal distress or fetal death [Odds Ratio (OR) 3.68; 95% Confidence Interval (CI) 1.36, 9.94], even after adjusting for maternal age and smoking status. Finally the infants of abused women were more likely to remain in hospital after their mother's discharge (OR: 3.75; 95% CI: 1.38, 10.23). Our findings suggest that fetuses may be compromised in utero, as shown by higher rates of fetal distress and fetal death found among women physically abused during pregnancy.

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References

1992Assessing for Abuse During Pregnancy 1990Violence during pregnancy and substance use.1985Physical abuse in pregnancy.1987Battered and pregnant: a prevalence study.1992Correlates of battering during pregnancy 1992Abuse of pregnant women and adverse birth outcome. Current knowledge and implications for practice 1989The Birth-Weight/Battering Connection 1991Identifying and Helping Battered Pregnant Women

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1998The Interrelationships Between Abuse Substance Use, and Psychosocial Stress During Pregnancy 2003Midwives' perceptions and experiences of routine enquiry for domestic violence 1998Attitudes and Practices of Registered Nurses Toward Women Who Have Experienced Abuse/Domestic Violence 2002Abuse during pregnancy and stress because of abuse during pregnancy and birthweight.1997Physical abuse and low birthweight: a case‐control study 1999Physical Abuse, Social Support, Self-Care, and Pregnancy Outcomes of Older Adolescents

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