Obstetric Outcomes Among Women With a History of Intimate Partner Violence in the United States.

Autor: Mead JS; Department of Obstetrics and Gynecology, Concord Hospital, Concord, the Department of Obstetrics and Gynecology, the Department of Epidemiology, and the Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Hanover, and the Department of Obstetrics and Gynecology and the Department of Pediatrics, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire; and the Department of Internal Medicine, University of New Mexico Health System, Albuquerque, New Mexico., Pollack CC, Paris AE, Emeny RT, Puleo RA, St Ivany AR
Jazyk: angličtina
Zdroj: Obstetrics and gynecology [Obstet Gynecol] 2023 Jul 01; Vol. 142 (1), pp. 80-89. Date of Electronic Publication: 2023 Jun 07.
DOI: 10.1097/AOG.0000000000005216
Abstrakt: Objective: To evaluate the association between exposure to intimate partner violence (IPV) and delivery method in a U.S. obstetric cohort.
Methods: The study population included U.S. women with a history of recent live birth, drawn from the 2009-2018 PRAMS (Pregnancy Risk Assessment Monitoring System) cohort. The primary exposure was self-reported IPV. The primary outcome of interest was method of delivery (vaginal or cesarean). Secondary outcomes included preterm birth, small for gestational age (SGA), and admission to the neonatal intensive care unit (NICU). Bivariate associations between the primary exposure (ie, self-report of IPV vs no self-report of IPV) and each covariate of interest were assessed with weighted quasibinomial logistic regression. Weighted multivariable logistic regression was conducted to evaluate the association between IPV and delivery method controlling for confounders.
Results: A total of 130,000 women were included in this secondary analysis of a cross-sectional sample, representing 7,500,000 women nationwide based on PRAMS sampling design. Of these, 0.8% reported abuse in the 12 months before their current pregnancy and 1.3% reported abuse during pregnancy; 1.6% of the study population reported abuse both before and during pregnancy. After adjusting for maternal sociodemographic characteristics, IPV exposure at any time was not significantly associated with cesarean delivery, compared with no IPV exposure (odds ratio [OR] 0.98, 95% CI 0.86-1.11). Of secondary outcomes, 9.4% of women experienced preterm birth and 15.1% had neonates admitted to the NICU. Exposure to IPV was associated with a 21.0% increased risk of preterm birth, compared with women without exposure (OR 1.21, 95% CI 1.05-1.40), and a 33.3% increased risk of NICU admission (OR 1.33, 95% CI 1.17-1.52) after controlling for confounders. There was no difference in the risk of delivering a neonate who was SGA.
Conclusion: Intimate partner violence was not associated with an increased risk of cesarean delivery. Intimate partner violence before or during pregnancy was associated with increased risk of adverse obstetric outcomes, such as preterm birth and NICU admission, corroborating previous research findings.
Competing Interests: Financial Disclosure Julia S. Mead disclosed receiving travel reimbursement related to a presentation at an ACOG district meeting in 2022. She also received payment from Daylight Design LLC, a graphic design organization in San Francisco, CA. The other authors did not report any potential conflicts of interest.
(Copyright © 2023 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.)
Databáze: MEDLINE