DOVE: Association between maternal exposure to Intimate Partner Violence (IPV) and being born Small for Gestational Age (SGA)

Background: IPV during pregnancy affects 9% to 17% of women in the US. The impact of IPV extends to health consequences for the neonate with a demonstrated direct association between the mother's violence experience and low birth weight and preterm birth (PB). Less is known about the association between maternal exposure to IPV and the risk for having an SGA baby. SGA fetuses are at increased risk of PB, and developmental and behavioral problems in childhood. Method: This longitudinal mixed-methods study examined the association between baseline violence scores of pregnant abused women (N=194, mean age= 26.0) participating in the Domestic Violence Enhanced Home Visitation Program (DOVE; RO1NROO9093, NINR/NIH), and their risk of delivering SGA babies. Baseline violence and SGA status were determined by the Severity of Violence Against Women Scale (SVAWS) and birth data respectively. Bivariate and multivariate logistic regression analyses were used to determine the association between IPV and risk of SGA. Results: 19% of study neonates were classified as SGA with rates slightly higher in urban neonates as compared to rural neonates (23% versus 17 %, p<0.05). Discussion: Maternal sexual abuse was significantly associated with having a SGA neonate in urban neonates in the unadjusted model (OR=1.16, p= 0.03, 95% CI =1.01-1.53). This association was attenuated after adjusting for other confounders. Infant's gender, mother's employment status and age were significantly associated with delivering a SGA neonate in the urban neonates. Future research should examine the types and severity of violence that women experience in relation to birth outcomes.