DOMESTIC ABUSE IN PREGNANCY AND ADVERSE BIRTH OUTCOMES

Summary

Principal Investigator: AUDREY FRIEDA SAFTLAS
Affiliation: University of Iowa
Country: USA
Abstract: Recent studies suggest that 2.4 % to 5.6 % of pregnant women are physically abused each year in the United States. Domestic violence is hypothesized to cause adverse pregnancy outcomes through two mechanisms: physical trauma and prenatal stress. To date, research into the association of domestic violence in pregnancy and adverse birth outcomes provides inconsistent evidence. Most studies, however, have been small in size, used an endpoint of low birthweight, and focused primarily on low-income women, who are at highest risk of both domestic violence and adverse pregnancy outcomes. We propose to conduct a population-based case-control study to investigate the independent and joint effects of domestic violence and prenatal stress on the risk of preterm delivery (N=950) and intrauterine growth retardation (N=1210). In addition, patterns of abuse will be examined over three points in time (prepregnancy, pregnancy, postpartum) among control subjects (N=950) to determine if the pregnancy or postpartum periods are high-risk times for domestic abuse. The influence of contextual factors, such as pregnancy intendedness, will also be examined. The study population, identified from the Iowa live birth certificate file, will be comprised of residents of three Iowa counties who deliver between August 1, 2001 and July 31, 2003. Domestic violence and prenatal stress will be assessed using well-tested, established instruments, including the revised Conflict Tactics Scale (CTS2) and the Prenatal Life Events Scale. Data will be collected using computer-assisted telephone interviews, covering the primary study exposures and risk factors for domestic violence and the two study outcomes. Subjects will be interviewed 3 to 6 months postpartum and compensated for their participation. Medical chart abstractions will be conducted to validate case definitions and document prenatal care variables, medical history, and pregnancy complications. With at least 80 % power, the study will be able to detect increased risks of 2.0 for the least prevalent exposure, domestic violence. This study will be the first to examine the effect of prenatal stress in conjunction with domestic violence on adverse pregnancy outcomes, and offers a unique combination of methodological and conceptual strengths to address these issues.
Funding Period: 2001-06-01 - 2008-05-31
more information: NIH RePORT

Top Publications

  1. pmc Correction of systematic bias in ultrasound dating in studies of small-for-gestational-age birth: an example from the Iowa Health in Pregnancy Study
    Karisa K Harland
    Injury Prevention Research Center and Department of Epidemiology, University of Iowa, Iowa City, IA 52242 5000, USA
    Am J Epidemiol 176:443-55. 2012
  2. pmc Cervical surgery for cervical intraepithelial neoplasia and prolonged time to conception of a live birth: a case-control study
    C N Spracklen
    Department of Epidemiology, University of Iowa College of Public Health, Iowa City, IA, USA
    BJOG 120:960-5. 2013
  3. ncbi Distress associated with prenatal screening for fetal abnormality
    Marci Lobel
    Department of Psychology, State University of New York, Stony Brook, NY, USA
    J Behav Med 28:65-76. 2005
  4. ncbi Explaining disproportionately high rates of adverse birth outcomes among African Americans: the impact of stress, racism, and related factors in pregnancy
    CHERYL L GISCOMBE
    Department of Psychology, Stony Brook University, Stony Brook, NY 11794 2500, USA
    Psychol Bull 131:662-83. 2005
  5. ncbi Combining conditional and unconditional recruitment incentives could facilitate telephone tracing in surveys of postpartum women
    Hind Beydoun
    Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA 52242, USA
    J Clin Epidemiol 59:732-8. 2006
  6. ncbi Prenatal maternal stress is associated with delivery analgesia and unplanned cesareans
    Tracie A Saunders
    Department of Anesthesiology, Stony Brook University, Stony Brook, NY 11794 2500, USA
    J Psychosom Obstet Gynaecol 27:141-6. 2006
  7. ncbi Psychosocial sequelae of cesarean delivery: review and analysis of their causes and implications
    Marci Lobel
    Department of Psychology, Stony Brook University, Stony Brook, NY 11794 2500, USA
    Soc Sci Med 64:2272-84. 2007
  8. doi Effects of written anger expression in chronic pain patients: making meaning from pain
    Jennifer E Graham
    Department of Biobehavioral Health, The Pennsylvania State University, 315 East Health and Human Development Building, University Park, PA 16802, USA
    J Behav Med 31:201-12. 2008

Scientific Experts

  • M Lobel
  • Jennifer E Graham
  • C N Spracklen
  • Karisa K Harland
  • Audrey F Saftlas
  • Tracie A Saunders
  • Hind Beydoun
  • CHERYL L GISCOMBE
  • B J Stegmann
  • K K Harland
  • A F Saftlas
  • Jerome Yankowitz
  • Elizabeth W Triche
  • M Bridget Zimmerman
  • Anne B Wallis
  • Christine Veloso
  • Elizabeth Triche
  • Bruce A Meyer
  • Kari Harland

Detail Information

Publications8

  1. pmc Correction of systematic bias in ultrasound dating in studies of small-for-gestational-age birth: an example from the Iowa Health in Pregnancy Study
    Karisa K Harland
    Injury Prevention Research Center and Department of Epidemiology, University of Iowa, Iowa City, IA 52242 5000, USA
    Am J Epidemiol 176:443-55. 2012
    ..9% and overestimated preterm delivery by 8.7%. This methodological approach can be applied by researchers using different study populations in similar research contexts...
  2. pmc Cervical surgery for cervical intraepithelial neoplasia and prolonged time to conception of a live birth: a case-control study
    C N Spracklen
    Department of Epidemiology, University of Iowa College of Public Health, Iowa City, IA, USA
    BJOG 120:960-5. 2013
    ..To determine whether women with a history of surgery for cervical intraepithelial neoplasia (CIN) are at an increased risk of subfertility, measured as a time to pregnancy of more than 12 months...
  3. ncbi Distress associated with prenatal screening for fetal abnormality
    Marci Lobel
    Department of Psychology, State University of New York, Stony Brook, NY, USA
    J Behav Med 28:65-76. 2005
    ..Study findings indicate that even in women who receive normal test results, AFP testing is associated with a modest degree of emotional disturbance which declines, but does not completely abate, after testing...
  4. ncbi Explaining disproportionately high rates of adverse birth outcomes among African Americans: the impact of stress, racism, and related factors in pregnancy
    CHERYL L GISCOMBE
    Department of Psychology, Stony Brook University, Stony Brook, NY 11794 2500, USA
    Psychol Bull 131:662-83. 2005
    ..There is a lack of studies examining the impact of such factors jointly and interactively. Recommendations and cautions for future research are offered...
  5. ncbi Combining conditional and unconditional recruitment incentives could facilitate telephone tracing in surveys of postpartum women
    Hind Beydoun
    Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA 52242, USA
    J Clin Epidemiol 59:732-8. 2006
    ..To compare tracing and contact rates using alternative incentives in a computer-assisted telephone interview (CATI) survey among postpartum women...
  6. ncbi Prenatal maternal stress is associated with delivery analgesia and unplanned cesareans
    Tracie A Saunders
    Department of Anesthesiology, Stony Brook University, Stony Brook, NY 11794 2500, USA
    J Psychosom Obstet Gynaecol 27:141-6. 2006
    ..Results indicate that PNMS contributes to higher likelihood of unplanned cesarean delivery through its association with delivery analgesia...
  7. ncbi Psychosocial sequelae of cesarean delivery: review and analysis of their causes and implications
    Marci Lobel
    Department of Psychology, Stony Brook University, Stony Brook, NY 11794 2500, USA
    Soc Sci Med 64:2272-84. 2007
    ....
  8. doi Effects of written anger expression in chronic pain patients: making meaning from pain
    Jennifer E Graham
    Department of Biobehavioral Health, The Pennsylvania State University, 315 East Health and Human Development Building, University Park, PA 16802, USA
    J Behav Med 31:201-12. 2008
    ..These findings suggest that expressing anger may be helpful for chronic pain sufferers, particularly if it leads to meaning-making...