Ethnic disparities in police-reported intimate partner violence and risk of hospitalization associated with pregnancy

Aims: To estimate annual hospitalization rates and incidence rate ratios (IRR) for pregnancy-related diagnoses by intimate partner violence (IPV) victimization status among non-Hispanic white, black and Hispanic women. Methods: This retrospective cohort study linked police-reported adult male-to-female IPV incident records from a southern U.S. metropolitan city with regional hospital discharge data. Census data constituted the denominator for the unexposed cohort. Age-adjusted [a]IRRs with 95% confidence intervals (CI) were calculated using Poisson or negative binomial maximum-likelihood regression. Results: The hospitalization rate associated with any obstetric diagnosis among women with reported IPV (92 per 1000 women) was comparable to that of the unexposed cohort. Rates were higher among black and white victims and lower among Hispanic victims compared to their unexposed counterparts (aIRR 1.44, CI 1.24-1.66; aIRR 1.31, CI 0.99-1.74; and aIRR 0.62, CI 0.46-0.84, respectively). Black and white victims also had significantly higher rates of hospitalization associated with a nondelivery obstetric diagnosis compared to the unexposed cohorts. Compared to their unexposed counterparts, black victims had significantly higher rates and Hispanic victims lower rates of delivery and any pregnancy complication; white victims had higher rates for any pregnancy complication. Rates for nondelivery pregnancy complications were higher for black and white victims (aIRR 1.58, CI 1.15-2.16 and aIRR 2.91, 1.54-5.50, respectively). Conclusions: Screening for IPV in hospital settings among pregnant women, especially those with antenatal complications, may identify a substantial number of women exposed to IPV. Further research is needed to discern the causes of ethnic disparities in IPV and pregnancy-related hospitalization.