Effects of abuse on maternal complications and birth weight in adult and adolescent women

Objective: To estimate the incidence of physical and sexual abuse in a sample of adult and adolescent pregnant women and to determine the relationship between abuse and maternal complications and infant birth weight. Methods: One thousand eight hundred ninety-seven women were screened for abuse during pregnancy. Maternal complications and infant birth weight were obtained by record review. Results: Physical abuse in the past year and/or during pregnancy was reported by 37.6% of the adolescent and 22.6% of the adult women (P < .001). Abused adult women were more likely to have unplanned pregnancies (P < .001) and to begin care after 20 weeks (P < .01) than nonabused women. For the aggregate sample of 1597 for whom birth weights were available, abuse was a significant risk factor for low birth weight (LBW) (P < .05) as was poor obstetric history (P < .05). Using Institute of Medicine risk factors for LEW, abused adults were more likely to have poorer past obstetric histories and to use tobacco, alcohol, and drugs (P < .05). Abused adolescents were at greater risk for smoking and first- or second-trimester bleeding (P < .05). For the aggregate, abused women were at greater risk for poor obstetric history, vaginal/cervical infection during pregnancy, smoking, and alcohol and drug use. Conclusion: More than one-third of the adolescent and nearly one-fourth of the adult women reported abuse in the past year and/or during pregnancy. Abuse is related to poor obstetric history, substance use, and LEW. The short abuse assessment screen detects potential abuse in order that interventions can be implemented. (Obstet Gynecol 1998;92: 530-4. (C) 1998 by The American College of Obstetricians and Gynecologists.).