Elsevier

Obstetrics & Gynecology

Volume 102, Issue 3, September 2003, Pages 557-564
Obstetrics & Gynecology

Original research
Impact of police-reported intimate partner violence during pregnancy on birth outcomes

https://doi.org/10.1016/S0029-7844(03)00573-8Get rights and content

Abstract

Objective

To examine the relationship of police-reported intimate partner violence during pregnancy and adverse birth outcomes.

Methods

We conducted a population-based, retrospective, cohort study in Seattle, Washington, using Seattle police data and Washington State birth certificate files from January 1995 through September 1999. Exposed subjects were women with an intimate partner violence incident reported to police during pregnancy and who subsequently had a singleton live birth or fetal death registered in the state of Washington. Unexposed subjects were randomly selected Seattle residents with a singleton live birth or fetal death in the same time period and who did not report an incident. The main outcome measures were low birth weight (LBW less than 2500 g), very LBW (VLBW less than 1500 g), preterm birth (20–36 weeks’ gestation), very preterm birth (20–31 weeks), and neonatal death (before discharge).

Results

Women reporting any partner violence during pregnancy were significantly more likely to have a LBW infant (adjusted odds ratio [aOR] 1.70; 95% confidence interval [CI] 1.20, 2.40), a VLBW infant (aOR 2.54; 95% CI 1.32, 4.91), a preterm birth (aOR 1.61; 95% CI 1.14, 2.28), a very preterm birth (aOR 3.71; 95% CI 1.80, 7.63), and a neonatal death (aOR 3.49; 95% CI 1.43, 8.50).

Conclusion

Police-reported partner violence during pregnancy is significantly associated with an increased risk of adverse birth outcomes. There is a critical need to identify pregnancy among women with reported incidents and to provide women health and social service information and referrals, particularly referrals to high-risk pregnancy programs.

Section snippets

Materials and methods

This was a population-based, retrospective, cohort study. Exposed subjects were women 16 to 49 years old who had reported one or more partner violence incidents to the Seattle Police Department in the years 1995 through 1998 and who subsequently had a singleton live birth or fetal death registered in the state of Washington within a time frame that indicated they were pregnant at the time of the incident. The time interval from incident to birth or fetal death was calculated from the birth

Results

Of the 389 abused women, 342 (87.9%) reported one incident during the index gestational period, 37 (9.5%) two incidents, and ten (2.6%) three to five incidents. Of the 389 incidents selected for analysis, the majority (72%) were categorized as physical violence. Approximately one third of women with reported partner violence during pregnancy were of non-Hispanic, white race/ethnicity and one third were non-Hispanic, black (Table 1). Over 80% were under 30 years old, and 20% were teenagers.

Women

Discussion

This study is one of the few population-based studies conducted to date and the first to examine the relationship between intimate partner violence and birth outcomes using police data. Measurement has been a consistent problem in previous studies of both prevalence of partner violence during pregnancy and outcomes related to partner violence. These studies rely on self-report, which may be constrained by the subject’s fear of her partner, shame or loss of self-esteem, entrapment and lack of

References (38)

  • J.A. Gazmararian et al.

    Prevalence of violence against pregnant women

    JAMA

    (1996)
  • M.F. MacDorman et al.

    Annual summary of vital statistics—2001

    Pediatrics

    (2002)
  • L.F. Bullock et al.

    The birth-weight/battering connection

    Am J Nurs

    (1989)
  • B. Parker et al.

    Abuse during pregnancyEffects on maternal complications and birth weight in adult and teenage women

    Obstet Gynecol

    (1994)
  • J. McFarlane et al.

    Abuse during pregnancyAssociations with maternal health and infant birth weight

    Nurs Res

    (1996)
  • J. Campbell et al.

    Physical and nonphysical partner abuse and other risk factors for low birth weight among full term and preterm babiesA multiethnic case-control study

    Am J Epidemiol

    (1999)
  • G. Maldonado et al.

    Simulation study of confounder-selection strategies

    Am J Epidemiol

    (1993)
  • M. Kotelchuck

    An evaluation of the Kessner Adequacy of Prenatal Care Index and a proposed Adequacy of Prenatal Care Utilization Index

    Am J Public Health

    (1994)
  • J.B. Gould

    Vital records for quality improvement

    Pediatrics

    (1999)
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