3201.0: Monday, November 13, 2000 - 4:45 PM

Abstract #11589

Prenatal violence and preterm birth: Potential mechanisms

Deborah L. Covington, DrPH1, Betsy J. Justason, MPH1, and Marvin Hage, MD2. (1) Research Department, Coastal Area Health Education Center, P.O. Box 9025, Wilmington, NC 28402, 910-343-0161, covi@med.unc.edu, (2) Ob/Gyn Department, Coastal Area Health Education Center, P.O. Box 9025, Wilmington, NC 28402

Purpose: The purpose of this study was to examine the relationship between prenatal violence and preterm birth and attempt to identify mechanisms of prenatal violence associated with preterm delivery. Methods: The prospective cohort study design included all 550 Medicaid-eligible, pregnant women who initiated maternity care coordination services in a health department clinic in 2 years. Care coordinators screened all women for violence using a validated, systematic assessment protocol three times during pregnancy by asking: "Have you been hit, slapped, kicked, or hurt during this pregnancy?" This assessment protocol was linked with prenatal care records and delivery records to document information on pregnancy complications. Results: A logistic regression model, which controlled for multiple risk factors, indicated that women who reported prenatal violence were significantly more likely to deliver preterm than women who did not report prenatal violence (OR=2.5, 95% CI=1.1, 5.6). Body site injured, timing of violence, and number of violent incidents were significantly associated with prenatal violence and preterm delivery. Women who experienced abdominal violence were significantly more likely to experience preterm delivery than those who reported violence to other body areas. Women who reported abdominal violence in the last trimester of pregnancy were much more likely to experience preterm delivery than those who experienced abdominal violence earlier in pregnancy. Furthermore, those who delivered preterm were more likely to report multiple incidents of violence. Conclusion: Our results indicate a need for interventions to reduce prenatal violence and its impact on preterm birth especially abdominal violence late in pregnancy.

Learning Objectives: 1. Recognize the significance of prenatal violence in relation to preterm labor. 2. Describe the impact of prenatal violence on preterm labor. 3. Describe the need for effective interventions to reduce prenatal violence and its impact

Keywords: Pregnancy Outcomes, Domestic Violence

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA