Elizabeth P LOCKINGTON MD , Helen C. SHERRELL FRANZCOG, PhD , Kylie CRAWFORD FANZCVS, PhD , Kym RAE PhD , Sailesh KUMAR FRCS, FRCOG, FRANZCOG DPhil(Oxon)Intimate partner violence is a significant risk factor for adverse pregnancy outcomes, AJOG Global Reports (2023), doi: https://doi.org/10.1016/j.xagr.2023.100283
Abstract
Background
Globally, almost 30% of women report experiencing intimate partner violence. In Australia, intimate partner violence is estimated to affect 2.0 – 4.3% of pregnant women. Those experiencing intimate partner violence in pregnancy have poorer perinatal and maternal outcomes including preterm birth, low birth weight, preterm pre-labor rupture of membranes, perinatal death, miscarriage, antepartum haemorrhage, maternal trauma and death.
Objective
To evaluate maternal and perinatal outcomes in women who report intimate partner violence in a tertiary Australian hospital.
Study Design
A retrospective observational study between January 2017 and December 2021 at the Mater Mother’s Hospital in Brisbane, Australia. The study cohort included pregnant women who had completed a prenatal intimate partner violence questionnaire. Exclusion criteria included infants with known major congenital or chromosomal abnormalities.
Results
Of the total study cohort of 45,177 births, 3242 births (7.2%) occurred in women exposed to intimate partner violence. Those who identified as Indigenous, or refugee status experienced significantly higher rates of intimate partner violence. Women exposed to intimate partner violence had greater odds of a small for gestational age infant (aOR 1.17, 95% CI 1.04 – 1.33), pre-term birth (aOR 1.21, 95% CI 1.07 – 1.37), preterm pre-labor rupture of membranes (aOR 1.23, 95% CI 1.05 – 1.45) and an infant with severe neonatal morbidity (aOR 1.21, 95% CI 1.08 – 1.35). Women reporting intimate partner violence also had higher odds of acute presentation to the obstetric assessment unit (aOR 1.71, 95% CI 1.58 – 1.85) and admission to hospital (aOR 1.44, 95% CI 1.30 – 1.61). Compared to non-Indigenous women exposed to intimate partner violence, women of Indigenous status had worse outcomes with significantly higher rates of preterm pre-labor rupture of membranes, extreme preterm birth, lower gestational age at birth, low birthweight and higher rates of infants with birthweight <5th percentile for gestation.
Conclusions
Intimate partner violence is associated with increased risks of poor perinatal outcomes particularly in those identifying as Indigenous and of refugee status. Our results reinforce the importance of purposefully screening for intimate partner violence in pregnancy and emphasize that mitigating this risk may improve pregnancy outcomes.
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