Perinatal morbidity associated with violence experienced by pregnant women

Abstract

OBJECTIVE: We investigated whether physical assault is independently associated with an adverse obstetric outcome. STUDY DESIGN: We compared the perinatal outcomes of 32 indigent women who reported being physically abused during pregnancy with those of 352 control subjects who denied ever being assaulted. Patients were classified into the appropriate category on the basis of a structured interview. Logistic regression analyses were performed to estimate the relative risk of adverse outcome while adjusting for confounders. RESULTS: Women assaulted in the current pregnancy were twice as likely to have preterm labor as compared with those who denied assault. In addition, crude odds ratios showed a twofold increased risk of chorioamnionitis in assault victims. No difference between abused and nonabused women was noted in the prevalence of preterm delivery, pregnancy-induced hypertension, cesarean section, meconium staining, infant birth weight, Apgar scores, intrauterine growth retardation, fetal distress, fetal death, neonatal seizures, sepsis, or admission to the intensive care unit. CONCLUSIONS: This study demonstrates that physical assault during pregnancy is associated with preterm labor and chorioamnionitis. Screening for ongoing assault should be incorporated into routine prenatal care to identify women at risk of complications. (AM J Obstet Gynecol 1994;170:1760-9.)