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Background: Intimate partner abuse of pregnant women has been linked to the delivery of low-birth-weight infants. Also, abused pregnant women have reported a greater prevalence of substance abuse, poor nutrition, and demographic risk factors for poor birth outcomes. These factors may play a role in the reported relation between intimate partner violence and birth weight.
Objectives: To explore the role of substance abuse (smoking, alcohol, and drug use) and weight gain of less than 15 pounds during pregnancy as potential mediators of the relation between recent partner abuse and infant birth weight, and to investigate the role of demographic risk factors as potential moderators for the impact of abuse on birth weight.
Methods: Data were extracted on abuse screening results, demographics, birth outcomes, and a range of medical and obstetric risks and complications from the medical records of 1,969 women who had been screened by clinicians for domestic abuse during pregnancy. Hypotheses were tested using multiple regression analysis.
Results: Recent physical or psychological abuse had a small but significant effect on birth weight in this sample. Smoking and low weight gain were weak but significant mediators of the relation between recent abuse and infant birth weight. Single marital status was the strongest demographic predictor of decreased birth weight. No moderator effects were found.
Conclusions: Although prospective studies are warranted, nursing care to reduce smoking and promote adequate weight gain in all women along with support for women's efforts to seek safety from abuse may help to improve birth outcomes and promote maternal well-being.
Intimate partner abuse affects as many as one in six pregnant women (Curry, Perrin, & Wall, 1998;Parker, McFarlane, & Soeken, 1994), making it one of the most common obstetric risks. Domestic violence during pregnancy has been linked repeatedly to delivery of low-birth-weight infants (Curry et al., 1998;Huth-Bocks, Levendosky, & Bogat, 2002;Parker et al., 1994). However, the mechanism for this link has not been fully explored.
Researchers now view abuse within a complex interaction of social and behavioral factors that decrease birth weight (Murphy, Schei, Myhr, & Du Mont, 2001). In a retrospective chart review, the role of selected health behaviors as mediators and demographic risk factors as moderators of the relation between recent domestic abuse and infant birth weight was explored. The findings suggest areas for future exploration, although the cross-sectional data prevent demonstration of the chronology or causality of these relations.
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