Abuse affects a woman's risk for preterm delivery, low-birth-weight children

  • Nesari M & al.
  • BMC Pregnancy Childbirth
  • 16 Oct 2018

  • curated by Elisabeth Aron, MD, MPH, FACOG
  • Clinical Essentials
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Takeaway

  • Abuse is associated with a woman's risk for preterm delivery (PTD) and having a low-birth-weight (LBW) infant.
  • Timing and length of abuse may be important as well.

Why this matters

  • When chronic stress tips over the threshold, a person may become vulnerable to disease.
  • A history of abuse may be associated with high-risk behaviors including tobacco, drug, and alcohol abuse as well as inadequate social support and prenatal care.

Key results

  • PTD (14 studies) risk increased with (ORs)
    • Abuse during childhood: 1.25 (P=.008);
    • Abuse during married life before pregnancy, but not significantly: 1.26 (P=.29); and
    • Abuse 12 months prior to pregnancy: 1.28 (P=.002).
  • LBW (11 studies; ORs):
    • Abuse during childhood increased risk of having a LBW infant: 1.57 (P=.06);
    • Abuse during married life before pregnancy did not increase the risk: 1.09 (P=.38);
    • Abuse 12 months prior to pregnancy increased risk: 1.35 (P=.0004).

Study design

  • Systematic review and meta-analysis (16 studies included in final analysis).
  • Funding: University of Alberta; Canadian Institutes of Health Research; Alberta Strategic Patient Oriented Research SUPPORT Unit.

Limitations

  • Heterogeneity among studies.
  • Pooling data does not account for confounders.

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