Role of mental health and intimate partner violence on neonatal outcomes in a sample of low income, African American women: A mixed-methods study

Background: IPV during pregnancy affects .9% to 17% of U.S. women and significantly impacts maternal mental health and neonatal health with higher rates of low birth weight and preterm birth. Gaps in the literature remain concerning relationships between maternal mental health, IPV, and adverse neonatal outcomes. This mixed-methods study is one of the first to examine the associations of these three health concerns in a sample of urban, low SES minority women. Methods: 166 women between 24-28 weeks gestation were recruited from three inner city obstetric clinics. Using criterion sampling, a sub-sample of 12 African American women participated in individual interviews. Results: 19% (n=32) of participants reported current abuse. Infants of women experiencing IPV were six times more likely to experience adverse outcomes (OR 6.08, 95% CI [2.23, 15.88], p <0.001). Women with worse mental health were 3.7 times more likely to experience an adverse neonatal outcome (OR 3.66, 95% CI [2.34, 5.72], p <0.001). Participants discussed how IPV influenced their unborn children. “The bruises were one thing but the constant stress made me vomit all the time.I had to get IVs…my poor baby will probably be small.” Another participant said “I worry because he's measuring small.I'm too stressed out to eat.” Conclusions: Reported prevalence rates for IPV, depression and PTSD were higher than previously reported. Given the overwhelming prevalence of IPV and its strong association in compromising a mother's mental health, practitioners and service providers working with pregnant women are urged to incorporate consideration of this into their practice.