Intimate Partner Violence and Maternal Cigarette Smoking Before and During Pregnancy

OBJECTIVE: To determine the association of intimate partner violence with maternal cigarette smoking before and during pregnancy. METHODS: Data were obtained for 196,391 U. S. mothers who delivered live neonates from 2004-2008 and completed the Pregnancy Risk Assessment Monitoring System survey 2-9 months postpartum. Intimate partner violence was defined as being physically hurt by a current or expartner in the year before or during pregnancy. Weighted descriptive and multivariate analyses were performed. RESULTS: Compared with nonphysically abused women, those who experienced physical abuse were 2.1 times more likely to smoke before pregnancy (44.0% compared with 21.0%, P<.001) and 2.6 times more likely to smoke during pregnancy (29.6% compared with 11.4%, P<.001). Smoking prevalence during pregnancy was highest for abused women who were non-Hispanic white (42.3% smoked) and lowest for nonabused college graduates (2.2% smoked). Smoking rates more than tripled for college graduates in abusive relationships (2.2% compared with 7.1%). After adjusting for potential confounding factors, abused women were significantly more likely to smoke during pregnancy than nonabused women (adjusted odds ratio 1.95, P<.001, 95% confidence interval 1.80-2.12). CONCLUSION: Women who experienced intimate partner violence had significantly higher rates of smoking before pregnancy and were less likely to quit during pregnancy than women who did not experience intimate partner violence. The American College of Obstetricians and Gynecologists and the U. S. Public Services Task Force recommend routine intimate partner violence screening with appropriate interventions to prevent violence against women, optimize safety, and improve health. Additional and targeted intimate partner violence assessment of women who smoke during pregnancy may prove especially beneficial.