Abuse during pregnancy: effects on maternal complications and birth weight in adult and teenage women.

OBJECTIVE

To determine the incidence of physical and sexual abuse in a sample of adult and teen pregnant women and to determine the effect of abuse on birth weight.

METHODS

One thousand two hundred three African-American, Hispanic, and white urban female residents were screened for abuse on their first prenatal visit and in the second and third trimesters. Infant birth weight was obtained by record review.

RESULTS

Abuse during pregnancy was reported by 20.6% of teens and 14.2% of the adult women (P < .01). Both abused teens and adults were more likely than nonabused women to enter prenatal care in the third trimester (21.9 versus 7.5%, P = .001 for teens; 15.8 versus 8.7%, P = .007 for adults). For the aggregate sample of 1203 women, abuse during pregnancy was a significant (P < .05) risk for low birth weight (LBW), as well as low maternal weight gain, infections, anemia, smoking, and use of alcohol or drugs. Using Institute of Medicine risk factors for LBW, abused adults were at significantly greater risk for poor obstetric history, short inter-pregnancy interval, infections, anemia, smoking, and alcohol or drug usage. Abused teens had a significantly greater risk for poor weight gain, first- or second-trimester bleeding, smoking, and alcohol or drug use.

CONCLUSIONS

One in five teens and one in six adult women experienced abuse during pregnancy. Abuse is related to LBW and late entry into prenatal care. Abuse can be documented readily with a short abuse assessment screen and interventions then initiated.