Abuse of Pregnant Women and Adverse Birth Outcome

Newberger, Eli H.; Barkan, Susan E.; Lieberman, Ellice; McCormick, Marie C.; Yllö, Kersti; Gary, Lisa T.; Schechter, Susan

doi:10.1001/jama.1992.03480170096037

Cited by 157 publications

(20 citation statements)

References 39 publications

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“…To date, this association has been attributed to a number of direct and indirect mechanisms. First, abdominal trauma and consequent placental damage and premature uterine contractions or rupture of membranes may explain a direct causal association (Newberger et al 1992; Campbell et al 1999). Further, infection or genital trauma resulting from forced sexual activity may increase the risk of adverse infant outcomes.…”

Section: Discussionmentioning

confidence: 99%

Intimate partner violence: associations with low infant birthweight in a South African birth cohort

et al. 2014

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Violence against women is a global public health problem. Exposure to intimate partner violence (IPV) during pregnancy has been associated with a number of adverse maternal and fetal outcomes, including delivery of a low birthweight (LBW) infant. However, there is a paucity of data from low-middle income countries (LMIC). We examined the association between antenatal IPV and subsequent LBW in a South African birth cohort. This study reports data from the Drakenstein Child Lung Health Study (DCLHS), a multidisciplinary birth cohort investigation of the influence of a number of antecedent risk factors on maternal and infant health outcomes over time. Pregnant women seeking antenatal care were recruited at two different primary care clinics in a low income, semi-rural area outside Cape Town, South Africa. Antenatal trauma exposure was assessed using the Childhood Trauma Questionnaire (CTQ) and an IPV assessment tool specifically designed for the purposes of this study. Potential confounding variables including maternal sociodemographics, pregnancy intention, partner support, biomedical and mental illness, substance use and psychosocial risk were also assessed. Bivariate and multiple regression analyses were performed to determine the association between IPV during pregnancy and delivery of an infant with LBW and/or low weight-for-age z (WAZ) scores. The final study sample comprised 263 mother-infant dyads. In multiple regression analyses, the model run was significant [r2=0.14 (adjusted r2=0.11, F(8, 212) = 4.16, p=0.0001]. Exposure to physical IPV occurring during the past year was found to be significantly associated with LBW [t=−2.04, p=0.0429] when controlling for study site (clinic), maternal height, ethnicity, socioeconomic status, substance use and childhood trauma. A significant association with decreased WAZ scores was not demonstrated. Exposure of pregnant women to IPV may impact newborn health. Further research is needed in this field to assess the relevant underlying mechanisms, to inform public health policies and to develop appropriate trauma IPV interventions for LMIC settings.

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Section: Discussionmentioning

confidence: 99%

Intimate partner violence: associations with low infant birthweight in a South African birth cohort

et al. 2014

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“…Accordingly, the impact of violence in the first trimester, for example, would be closer to 100 grams, once we correct for selection. The second interpretation is that this effect captures the indirect effects of violence on birth outcomes as discussed by Newberger (1992). These indirect effects include exacerbation of chronic illnesses such as hypertension, diabetes or asthma, stress, inadequate access to prenatal care, behavioral risks such as smoking, and inadequate maternal nutrition.…”

Section: Data Empirical Methods and Resultsmentioning

confidence: 99%

“…Direct effects from blunt trauma to the maternal abdomen include abruptio placentae, fetal fractures, rupture of the maternal uterus, liver, spleen and antepartum hemorrhage. Indirect effects of violence include 1) the exacerbation of chronic illnesses such as hypertension, diabetes or asthma which can negatively affect the fetus, 2) elevated stress, 3) inadequate access to prenatal care, 4) behavioral risks such as smoking, and 5) inadequate maternal nutrition (Newberger, et al, 1992). …”

Section: Background On Domestic Violencementioning

confidence: 99%

Poverty, Violence, and Health

Aizer¹

2011

J. Human Resources

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Two percent of women in the US suffer from intimate partner violence annually, with poor and minority women disproportionately affected. I provide evidence of an important negative externality associated with domestic violence by estimating a negative and causal relationship between violence during pregnancy and newborn health, exploiting variation in the enforcement of laws against domestic violence for identification. I find that hospitalization for an assault while pregnant reduces birth weight by 163 grams. This sheds new light on the infant health production process as well as observed income gradients in health given that poor mothers are disproportionately affected by violence.

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“…Direct physical violence mechanisms such as abdominal trauma can lead to abruption placenta and fetal loss, maternal hemorrhage, and early onset of labor and delivery. 38 Exposure to abusive environments may also lead to intermediate risks such as elevated physical and physiological stress, which in turn, may lead to diminished fetal growth and early onset of labor. While we did not have individual-level measures of domestic violence, even the neighborhood-level marker is some indication of the level of violence in the homes of residents.…”

Section: Discussionmentioning

confidence: 99%

Living in violence: Neighborhood domestic violence and small for gestational age births

2017

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Objectives To determine the association between neighborhood domestic violence and small-for-gestational-age (SGA) birth and to examine if there is a differential impact of neighborhood domestic violence on SGA births by race in a high crime community. Methods This analysis includes all birth records issued in New Orleans, Louisiana from 2011–2012 geocoded by census tract (N=177 census tracts, N=8,322 women). Hierarchical modeling and ecologic spatial analysis were used to examine the area-effect of neighborhood domestic violence on SGA births, independent of individual-level predictors and accounting for the propensity to live in high domestic violence neighborhoods. Results Tests for spatial autocorrelation reveled area-level clustering and overlap of SGA and domestic violent rates. Pregnant women living in high domestic violence areas were more likely to give birth to an SGA infant compared to women in low-domestic violence areas (OR=1.04, 95%CI: 1.01, 1.08), net of the effects of individual-level factors and propensity scores. Conclusion Neighborhood-level attributes including rates of domestic violence may increase women’s risk for SGA birth, highlighting a policy-relevant and potentially amenable exposure.

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Abuse of Pregnant Women and Adverse Birth Outcome

Cited by 157 publications

References 39 publications

Intimate partner violence: associations with low infant birthweight in a South African birth cohort

Intimate partner violence: associations with low infant birthweight in a South African birth cohort

Poverty, Violence, and Health

Living in violence: Neighborhood domestic violence and small for gestational age births

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