Severity, manifestations, and consequences of violence among pregnant adolescents

• Published in: Journal of adolescent health Vol. 28; no. 1; pp. 55 - 61
• Main Authors: Covington, Deborah L, Justason, Betsy J, Wright, Lydia N
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 2001; Elsevier Science
• Subjects: Adolescent; Adolescent Parents; Adolescents; Adult; Biological and medical sciences; Cohort Studies; Confidence Intervals; Domestic violence; Family Violence; Female; Humans; Logistic Models; Medical sciences; North Carolina; Pregnancy; Pregnancy in Adolescence - statistics & numerical data; Pregnancy Outcome; Pregnant adolescent girls; Premature births; Prenatal Care; Prevalence; Prospective Studies; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Risk; Surveys and Questionnaires; USA; Victimology; Violence - statistics & numerical data; North Carolina; Pregnancy; Domestic violence; Adolescents; Pregnancy outcome; Prenatal care; Human; Consumption; Marital relation; Violence; Victimology; Prenatal; Alcoholic beverage; Tobacco; Social interaction; Adolescent; Risk factor; Adult; Female; Woman abuse; Age
• ISSN: 1054-139X; 1879-1972
• DOI: 10.1016/S1054-139X(00)00154-3

Purpose: To examine the severity, manifestations, and consequences of prenatal violence among adolescent and adult participants in a county health department prenatal care coordination program. Methods: The prospective cohort study design included all Medicaid-eligible program participants from 1994 to 1996. Care coordinators screened participants for prenatal violence using a validated, systematic violence assessment protocol at three times during pregnancy. This protocol was linked with prenatal care and hospital delivery records to document pregnancy outcomes. The main outcome variables were low birth weight (<2500 g) and preterm delivery (before 37 weeks’ gestation). Results: Among teens, 16.1% reported prenatal violence, including 9.4% who reported severe violence such as hitting, kicking, or stabbing. Among adults, 11.6% reported prenatal violence, including 4.8% who reported severe violence. Teens were more likely than adults to report abdominal trauma (56% vs. 22%) and violence perpetrated by a relative (23% vs. 5%). Teens who reported severe prenatal violence were more likely to report alcohol use. They were significantly more likely to deliver preterm than teens who reported “other” or “no” prenatal violence (odds ratio 3.5, 95% confidence interval 1.1–10.8) when adjusting for race, adequacy of prenatal care, prior preterm delivery, and alcohol use. For adults, the relationship between prenatal violence and preterm delivery was not statistically significant. The relationship between prenatal violence and low birth weight was not significant for either age cohort. Conclusions: Prenatal violence was a significant risk factor for preterm birth in this population, especially among teens.