Abuse during pregnancy: associations with maternal health and infant birth weight

Abstract

A stratified, prospective cohort analysis was completed on 1,203 African American, Hispanic, and white women. All women were assessed for abuse at the first prenatal visit and twice more during pregnancy. They were also assessed for risk factors of low birth weight using Institute of Medicine correlates. Prevalence of physical or sexual abuse during pregnancy was 16% (1 of 6). Abused women were twice as likely to begin prenatal care during the third trimester, with abuse preceding late entry. Abuse was recurrent, with 60% of the women reporting repeated episodes. More severe abuse was significantly correlated with lower infant birth weights for all three ethnic groups. Abuse during pregnancy was a significant risk for low birth weight as well as maternal low weight gain, infections, anemia, smoking, and use of alcohol and drugs. When compared to women who were not abused, women abused during pregnancy delivered infants averaging 133 g less. Abused white women delivered infants with the greatest reduction in birth weight.

PIP: This paper presents a stratified, prospective cohort study that examined the relationship of abuse during pregnancy and low birth weight. The study covered a total of 1203 pregnant African American, Hispanic and White women who were assessed for abuse during the first prenatal and subsequent clinical visits. Using the Institute of Medicine risk factors which is classified into 5 groups: 1) demographic risks; 2) medical risks predating pregnancy; 3) medical risks in current pregnancy; 4) behavioral risks; and 5) inadequate prenatal care, the risk factors for low birth weight were examined. Physical and sexual abuses were reported among 16% of the subjects, with a higher percentage among African Americans (18%), followed by Whites (17%) and Hispanics (13%). Repetitive abuse was observed in 60% of the women with more severe abuse among those who began prenatal care during the third trimester. This study confirms that abuse during pregnancy is a significant risk factor for low infant birth weight, as well as maternal low weight gain, infections, anemia, smoking, and use of alcohol and drugs. Children delivered by women abused during pregnancy were reported to weigh 133 g less in comparison to women who were not abused. Abused White women delivered infants with the greatest reduction in birth weight.