Intimate Partner Violence and Gestational Weight Gain in a Population-Based Sample of Perinatal Women

Abstract

Objective To examine the effects of intimate partner violence (IPV) at varied time points in the perinatal period on inadequate and excessive gestational weight gain. Design Retrospective cohort using population-based secondary data. Setting Pregnancy Risk Assessment Monitoring System and birth certificate data, including New York City and 35 states. Participants Data were obtained for 251,342 U.S. mothers who gave birth from 2004–2011 and completed the Pregnancy Risk Assessment Monitoring System survey 2–9 months after birth. Methods The exposure was perinatal IPV, defined as experiencing physical abuse by a current or ex-partner in the year before or during pregnancy. Adequacy of gestational weight gain (GWG) was categorized using 2009 Institute of Medicine guidelines. Weighted descriptive statistics and multivariate logistic regression models were used. Results Approximately 6% of participants reported perinatal IPV, 2.7% of participants reported IPV in the year before pregnancy, 1.1% reported IPV during pregnancy only, and the remaining 2.5% reported IPV before and during pregnancy. Inadequate GWG was more prevalent among participants who experienced IPV during pregnancy and those who experienced IPV before and during pregnancy (23.3% and 23.5%, respectively) than in participants who reported no IPV (20.2%; P < 0.001). Participants who experienced IPV before pregnancy only were significantly more likely to have excessive GWG (P < 0.001). Results were attenuated in the multivariate modeling; only participants who experienced IPV before pregnancy had weakly significant odds of excessive GWG (aOR 1.14, 95% CI 1.02–1.26). Conclusions The association between perinatal IPV with inadequate GWG was explained by confounding variables; however, women who reported perinatal IPV had higher rates of GWG outside of the optimal range. Future studies are needed to determine how relevant confounding variables may affect a woman’s gestational weight gain.

Intimate partner violence and perinatal health: a systematic review

“…Once duplicates had been eliminated and titles and abstracts had been screened, 127 potentially relevant studies were selected and read in full. Ultimately, 50 studies ( n = 33 190 558 women) were included (Figure ). A summary of the results shown is presented in Table S1, which includes the characteristics of the population and studies, the types and proportion of population in the study reporting IPV, perinatal health outcomes reported and the quantification of the strength of association with different types of outcomes.…”

“…Forty‐one studies (82%, n = 41) were of high methodological quality (indicating low risk of bias) (Table ) . Most of the studies with high or moderate risk of bias obtained low scores in sample selection or comparability …”

“…The most frequently associated outcomes were low birthweight, followed by pre‐term birth, premature rupture of membranes, and perinatal death . Other outcomes associated were bleeding or haemorrhage during pregnancy, inadequate gestational weight gain, small‐for‐gestational‐age neonate, and urinary tract infection …”

“…Forty-one studies (82%, n = 41) were of high methodological quality (indicating low risk of bias) ( Table 2). [18][19][20][21][22][23][24][25][26]28,29,[31][32][33][34][35][36][37][38][39][40][41]43,[46][47][48][49][51][52][53][56][57][58][59][60][61][62][63][65][66][67] Most of the studies with high or moderate risk of bias obtained low scores in sample selection 30,45,50,54,55,64 or comparability. 27,45,50,…”

“…The most frequently associated outcomes were low birthweight, 19,20,32,33,37,40,59 followed by pre-term birth, 32,33,37,53,57,59 premature rupture of membranes, 19,25,33,37,60 and perinatal death. 33,37,51,65 Other outcomes associated were bleeding or haemorrhage during pregnancy, 25,37,47 inadequate gestational weight gain, 22,26,60 small-for-gestational-age neonate, 21,33 and urinary tract infection. 25,37 Psychological IPV was associated with eight perinatal health outcomes in six studies.…”