(878) Intimate partner violence is associated with increased adverse perinatal outcomes

Objective: Pregnancy is a high-risk time for intimate partner violence (IPV), with varying estimates of IPV prevalence globally. Existing population-level research on IPV in pregnancy often examines cohorts outside of the United States (US). The objective of this study is to examine the association between IPV in pregnancy and perinatal outcomes in a large, US-based cohort.

Study Design: This is a retrospective cohort study using California linked vital statistics and hospital discharge data from 2016-2019. We included singleton, non-anomalous births with gestational age 23-42 weeks. IPV was identified using International Classification of Diseases (ICD-10-CM) codes. Chi-square tests and multivariable logistic regression models were to determine association of IPV in pregnancy with perinatal outcomes.

Results: A total of 1,518,741 births were included, of which 2,756 (0.2%) had reported IPV in pregnancy. Compared with no reported IPV, pregnancies with IPV had higher proportions of chorioamnionitis (6.6% vs. 3.3%; p< 0.001), severe maternal mortality (SMM) (2.5% vs. 1.3%; p< 0.001), preterm delivery < 37 weeks (9.1% vs. 6.8%; p< 0.001), and neonatal intensive care unit (NICU) admission (11.8% vs. 8.6%; p< 0.001). Pregnancies with reported IPV had increased odds of preeclampsia (aOR=1.41, (1.21, 1.65)), chorioamnionitis (aOR=2.23, (1.90, 2.61)), placental abruption (aOR=1.68, (1.27, 2.24)), and SMM (aOR=1.73, (1.35, 2.21)). With regards to neonatal outcomes, reported IPV in pregnancy was associated with increased odds of Apgar score < 7 at 5 minutes (aOR=2.02, (1.58, 2.59)) and NICU admission (aOR=1.23, (1.09, 1.38)). We did not find a statistically significant difference in preterm birth < 32 weeks, small for gestational age, stillbirth, or infant death.

Conclusion: IPV in pregnancy is associated with increased odds of adverse maternal outcomes, as well as increased odds of Apgar score < 7 at 5 minutes and NICU admission. The results of this study reinforce the need for universal screening for IPV in pregnancy to inform care in during this high-risk period.