Original Articles
Effects of abuse on maternal complications and birth weight in adult and adolescent women

https://doi.org/10.1016/S0029-7844(98)00258-0Get rights and content

Abstract

Objective: To estimate the incidence of physical and sexual abuse in a sample of adult and adolescent pregnant women and to determine the relationship between abuse and maternal complications and infant birth weight.

Methods: One thousand eight hundred ninety-seven women were screened for abuse during pregnancy. Maternal complications and infant birth weight were obtained by record review.

Results: Physical abuse in the past year and/or during pregnancy was reported by 37.6% of the adolescent and 22.6% of the adult women (P < .001). Abused adult women were more likely to have unplanned pregnancies (P < .001) and to begin care after 20 weeks (P < .01) than nonabused women. For the aggregate sample of 1597 for whom birth weights were available, abuse was a significant risk factor for low birth weight (LBW) (P < .05) as was poor obstetric history (P < .05). Using Institute of Medicine risk factors for LBW, abused adults were more likely to have poorer past obstetric histories and to use tobacco, alcohol, and drugs (P < .05). Abused adolescents were at greater risk for smoking and first- or second-trimester bleeding (P < .05). For the aggregate, abused women were at greater risk for poor obstetric history, vaginal/cervical infection during pregnancy, smoking, and alcohol and drug use.

Conclusion: More than one-third of the adolescent and nearly one-fourth of the adult women reported abuse in the past year and/or during pregnancy. Abuse is related to poor obstetric history, substance use, and LBW. The short abuse assessment screen detects potential abuse in order that interventions can be implemented.

Section snippets

Materials and methods

This prospective study was conducted in the greater metropolitan area of Portland, Oregon, between March 1993 and August 1996. Using procedures and consent forms approved by appropriate Institutional Review Boards, we interviewed 1897 women attending one of six prenatal clinics. The majority were white (58%). The remainder were black (26.6%), Hispanic (4.9%), native American (3.0%), Asian (2.6%), and “other” (4.9%). Thirty percent (n = 559) were adolescents, and 70% (n = 1338) were adults.

Results

Of the 1897 women screened for abuse during pregnancy, 513 (27%) reported physical or sexual abuse in the past year and/or physical abuse since pregnancy. Overall, 4.5% reported sexual abuse in the past year. Adolescents were significantly more likely to report abuse (37.6%) than adults (22.6%) (χ2 = 44.94, df = 1, P < .001). Women who were classified as black, native American, or “other” also reported significantly higher research rates of abuse than other ethnic groups (χ2 = 15.16, df = 5, P

Discussion

Our study found similarly high rates of abuse among pregnant adult and adolescent women, as reported by Parker et al.5 Both studies used the same three screening questions to measure abuse, had exactly the same proportion of adults and adolescents, and were of predominately low-income women, which controlled for the intervening effects of poverty. Adults in both studies had the same rates of physical and sexual abuse in the year before pregnancy (23%). Although adolescents in our study reported

References (19)

There are more references available in the full text version of this article.

Cited by (0)

Funded by NIH (R01-NR02696).

View full text