Immediate and long-term outcomes of assault in pregnancy

• Published in: Australian & New Zealand journal of obstetrics & gynaecology 2014-06, Vol.54 (3), p.256-262
• Main Authors: Gulliver, Pauline J., Dixon, Robyn S.
• Format: Article
• Language: English
• Subjects: Abortion, Spontaneous - etiology; Adult; epidemiology; Female; Humans; New Zealand; Obstetric Labor, Premature - etiology; Pregnancy; Pregnancy Complications - etiology; Pregnancy Outcome; Retrospective Studies; Stillbirth; Violence
• ISSN: 0004-8666; 1479-828X
• DOI: 10.1111/ajo.12175

Objective We examined the immediate and long‐term health outcomes of hospitalised pregnancy‐related assault. Methods A retrospective review of hospital records was conducted using data from the New Zealand Ministry of Health's National Minimum Data Set of hospital discharges. The hospital records of pregnant women admitted to a public hospital in New Zealand between 2001 and 2006 were included in this investigation. Unique identifiers were used to identify the index pregnancy event, subsequent discharge events and mortality for five years after the index event. Discharge records were grouped as follows: pregnancy‐related hospital admission, but no associated or subsequent assault recorded (pregnant only); an assault‐related hospital admission event after the pregnancy, but within five years of the index pregnancy (assault after pregnancy); an assault recorded within the same hospital admission event as the pregnancy (assault during pregnancy). Generalised linear models for the binomial family were conducted to explore increased risk ratios of adverse maternal, fetal and subsequent injury outcomes depending on group assignment. Results Compared with the pregnancy‐only group, the assault after pregnancy and assault during pregnancy groups had increased risk ratios for death, preterm labour, antepartum haemorrhage, infectious complication, spontaneous abortion and stillbirth. Conclusion Assault during pregnancy substantially increased the risks for a number of adverse maternal and fetal outcomes. The identification of women who live in a violent relationship and the provision of adequate social support to these women may reduce the risks of subsequent injury and adverse maternal and fetal outcomes.