CLINICAL STUDIESPhysical Abuse, Smoking, and Substance Use During Pregnancy: Prevalence, Interrelationships, and Effects on Birth Weight
Section snippets
Physical Abuse During Pregnancy
Physical abuse during pregnancy recently has been recognized as a risk to the health of the mother and fetus (American College of Obstetricians and Gynecologists, 1988; Newberger et al., 1992; U.S. Public Health Service, 1986). Retrospective studies of women in shelters document that 40% to 60% of the women were abused during pregnancy (Walker, 1984). Abused women have reported blows to the pregnant abdomen, breasts, and genitals accompanied by sexual assault (Dobash and Dobash, 1979, Martin,
Methods
A prospective cohort design was followed.
Results
The demographic characteristics, abuse, smoking, and alcohol/illicit drug use status appear in Table 1, along with low-birth-weight deliveries. The ethnic composition of the sample was 34.4% African American, 34.2% Hispanic
(primarily Mexican American), and 31.3% white. Most women were ages 20–29 years, but 30% were adolescents. All were urban residents, and most (94%) had incomes below the poverty level, which is defined as eligibility for the Supplemental Food Program for Women, Infants, and
Discussion
Physical abuse during pregnancy is common, readily detected with a five-question screen, and associated with significantly higher use of tobacco, alcohol, and illicit drugs. Ethnic-specific interrelationships exist. White women who were abused had the highest prevalence of tobacco use, which was associated significantly with low infant birth weight. African-American women who were abused had the highest prevalence of alcohol/illicit drug use, with significant lowering effects on infant birth
Acknowledgment
This study was supported by grant R49/CCR603514- 01 from the Division of Injury Epidemiology and Injury Control, Centers for Disease Control, Atlanta, GA.
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