Boston, MA -- In the first national study of the effects of intimate partner violence on the health of women during pregnancy and the health of newborn children, researchers from the Harvard School of Public Health (HSPH) demonstrated that violence from male partners, both in the year prior to and during a woman's pregnancy, increases her risk of serious health complications during pregnancy. Such abuse also increases a woman's risk of delivering prematurely and that her child will be born clinically underweight and in need of intensive care. The paper appears in the July 2006 issue of the American Journal of Obstetrics and Gynecology (www.medical-library.org/j_obg.htm).
Although it has been previously documented that intimate partner violence against women affects one in four U.S. women, and numerous health consequences have been associated with being a victim of such violence, this is the first study to conclusively demonstrate that physical abuse from husbands or boyfriends compromises a woman's health during pregnancy, her likelihood of carrying a child to term and the health of her newborn. Women experiencing abuse in the year prior to and/or during a recent pregnancy were 40 percent to 60 percent more likely than non-abused women to report high-blood pressure, vaginal bleeding, severe nausea, kidney or urinary tract infections and hospitalization during this pregnancy. Abused women were 37 percent more likely to deliver preterm, and children of abused women were 17 percent more likely to be born underweight. Both of these conditions pose grave health risks to newborns, and children born to abused mothers were over 30 percent more likely than other children to require intensive care upon birth.
The researchers, led by Jay Silverman, assistant professor of society, human development and health at HSPH, and senior author Anita Raj, associate professor of social and behavioral sciences at Boston University School of Public Health, examined data on more than 118,000 women who gave birth to live infants during the years 2000 to 2003 from the Pregnancy Risk Assessment Monitoring System, established by the Centers for Disease Control and Prevention (CDC) to gather information from women around the time of pregnancy.
The authors propose a number of possible mechanisms to explain the association between intimate partner violence and maternal and infant health. "It may be that stress resulting from abuse is having a negative impact on the reproductive endocrine system and leading to poor outcomes during pregnancy," said Silverman. "Depression, known to result from abuse, has been shown to negatively affect fetal development. Sexual assault commonly co-occurs with physical violence from male partners and may lead to both greater risk of bleeding and urinary tract infections. Also, sexually transmitted infections are significantly more common among women abused by male partners, and such infections are known to compromise health during pregnancy and fetal development. We need to conduct far more research in this area to understand the mechanisms at work, but regardless of the mechanisms, it is clear that abuse from husbands and boyfriends represents a serious risk to the health of women, their pregnancies, and their newborn children."
The study builds on previous research showing the risks posed to women by male partners. "Although we have known for some time that men who abuse their wives and girlfriends also pose a serious risk to the children of those women because they are more likely to abuse children than other men, we now know that the risk to children from such men extends back into the prenatal period. As a society, we cannot afford to allow prevention of this grave threat to so many mothers and children to remain a low public health priority," Silverman said.
This study was supported by a grant from the Division of Reproductive Health of the Centers for Disease Control and Prevention.
Harvard School of Public Health is dedicated to advancing the public's health through learning, discovery, and communication. More than 300 faculty members are engaged in teaching and training the 900-plus student body in a broad spectrum of disciplines crucial to the health and well being of individuals and populations around the world. Programs and projects range from the molecular biology of AIDS vaccines to the epidemiology of cancer; from risk analysis to violence prevention; from maternal and children's health to quality of care measurement; from health care management to international health and human rights. For more information on the school visit: www.hsph.harvard.edu
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