204935 Prospective study of sexual, physical, and emotional violence and associated maternal and infant health risks among postpartum adolescents

Monday, November 9, 2009: 5:00 PM

Alpna Agrawal, MPH , Department of Maternal and Child Health and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
Jeannette Ickovics, PhD , School of Public Health, Yale University, New Haven, CT
Jessica Lewis, LMFT , Yale University School of Public Health, New Haven, CT
Urania Magriples, MD , Department of Obstetrics, Gynecology & Reproductive Sciences, Yale University School of Medicine, New Haven, CT
Trace Kershaw, PhD , School of Public Health, Yale University, New Haven, CT
Purpose: Among adolescent mothers during the postpartum period, few studies have examined the prevalence of intimate partner violence (IPV) by type (i.e., sexual, physical, and emotional), and the independent effect of each type on psychosocial maternal and infant health outcomes. Data: Sample of pregnant women aged 15-24 enrolled in a RCT of an HIV prevention intervention at two U.S. urban obstetrics and gynecology clinics in 2001-2004. Baseline interviews were completed during participants' second trimester (n=1,047). Follow-up surveys were collected 6 months (n=784) and 12 months postpartum (n=840). Methods: Logistic and linear regression models assessed the association between each IPV type (i.e., sexual, physical, and emotional) and maternal and infant health outcomes adjusting for socio-demographic effects. Results: Overall prevalence of physical or sexual violence was 15% and emotional violence 30% postpartum. The relative risk of revictimization 6 months after an event ranged from 2.9-3.5 across IPV types. For mothers, physical and emotional violence at 6 months was associated with less post-traumatic growth and increased stress and depression at 12 months. Sexual violence at 6 months increased odds of clinical STI diagnosis at 12 months. All IPV types at 6 months were associated with increased infant dysfunction, sleep dysregulation, and attention problems at 12 months. Conclusions: Adolescent mothers remain at risk of IPV after pregnancy. IPV experienced postpartum is associated with adverse psychosocial and behavioral maternal and infant health outcomes. Screening for IPV, including emotional violence, among young mothers may prevent long-term ill-health effects for both mother and child.

Learning Objectives:
1. Describe prevalence of sexual, physical, and emotional violence among postpartum adolescents 2. Identify adverse maternal and infant health outcomes associated with each IPV type 3. Discuss findings’ programmatic relevance to screening for abused, postpartum adolescents in the clinical setting

Keywords: Violence, Adolescent Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: 1. Doctoral candidate in Department of Maternal and Child Health. 2. Previously presented oral presentation at APHA in related research area.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.