299871
Intimate partner violence among delivery-related discharges in the United States and its impact on maternal-fetal pregnancy outcomes. HCUP (NIS), 2002-2009
Background: Intimate partner violence (IPV) is a growing public health concern in the United States. Data from 27 states and the city of New York showed a 3.6% IPV prevalence among women who gave birth from 2004-2007. Method: We used the Nationwide Inpatient Sample (NIS) dataset from HCUP (2002-2009). We diagnosed IPV and an array of maternal-fetal outcomes in maternal delivery hospitalizations using International Classification of Diseases, Ninth Revision, Clinical Modifications (ICD-9-CM) codes. The distribution of IPV by selected socio-demographic, behavioral, geographic, and hospital characteristics, was assessed using descriptive statistics. Survey logistic regression was used to examine the association between IPV and each adverse pregnancy outcome. Joinpoint regression was then used to investigate temporal trends in IPV over the 8-year study period. Results: A total of 3,649 cases of IPV were identified among the 32,658,259 delivery-related hospitalizations yielding a prevalence of 11.2 (95% CI=10.0-12.4) per 100,000 deliveries. From 2002-2009, there was no significant increase in the rate of IPV in this study. After adjustment for potential confounders, delivery discharges with an IPV diagnosis were at an increased risk of cesarean delivery [OR=1.29 (95% CI= 1.08, 1.54)], preterm delivery [OR=1.97 (95% CI= 1.59, 2.44)], prolonged hospital stay (≥ 4days) [OR=2.43 (95% CI= 2.04, 2.91)], anxiety [OR=2.57 (95% CI= 1.40, 4.73)], fetal death [OR=3.34 (95% CI= 1.99, 5.61)], stillbirth [OR=4.12 (95% CI=2.75, 6.17)], and, depression [OR=6.05 (95% CI= 4.51 8.12)], Conclusion: Public health efforts to alleviate adverse birth outcomes should consider IPV as a significant risk factor.
Learning Areas:
EpidemiologyPublic health or related research
Learning Objectives:
Describe factors associated with IPV diagnosis among delivery-related discharges.
Identify demographic, behavioral, and clinical conditions associated with adverse birth outcomes.
Discuss the importance of prevention and management of IPV among pregnant women.
Keyword(s): Birth Outcomes, Domestic Violence
Qualified on the content I am responsible for because: I have the required educational background and expertise evidenced by my peer reviewed publications in the areas of perinatal epidemiology birth outcomes.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.