Effect of Abuse During Pregnancy on Maternal and Child Safety and Functioning for 24 Months After Delivery

McFarlane, Judith DrPH, FAAN; Maddoux, John MA; Cesario, Sandra PhD; Koci, Anne PhD; Liu, Fuqin PhD; Gilroy, Heidi MS; Bianchi, Ann L. MS

Obstetrics & Gynecology:
doi: 10.1097/AOG.0000000000000183
Contents: Original Research
Abstract

OBJECTIVE: To evaluate the long-term safety and functioning outcomes for abused women reporting abuse during pregnancy and their children's behavior compared with abused women who do not report abuse during pregnancy.

METHODS: Forty-six abused women seeking assistance for partner abuse and reporting being pregnant during the preceding 4 months were evaluated every 4 months for 24 months to compare levels of abuse, danger for murder, anxiety, depression, somatization, and posttraumatic stress disorder (PTSD) for abused women who report abuse during pregnancy (n=24) compared with abused women reporting abuse only outside of pregnancy (n=22). Internalizing and externalizing behavior scores were evaluated for the children.

RESULTS: At entry into the study, abused women reporting abuse during pregnancy reported significantly greater (P<.05) threats of abuse, sexual abuse, physical abuse, danger for murder, and PTSD compared with abused women not reporting abuse during pregnancy. Effect sizes were large. When evaluated over the course of 24 months after delivery, risk for murder remained higher for women reporting abuse during pregnancy for 8 months after delivery, depression was higher at 4, 8, 16, and 20 months after delivery, and PTSD was appreciably higher for 24 months. Children living with mothers abused during pregnancy displayed more behavioral problems for the entire 24-month period, especially problems of depression and anxiety.

CONCLUSION: The study documents the negative safety and function effects of abuse in pregnant women that remain for at least 24 months after delivery. This warrants incorporating abuse screening during the antenatal and postdelivery periods and a protocol of care during the antenatal period and beyond.

LEVEL OF EVIDENCE: II

In Brief

Abuse during pregnancy compared with abuse only outside of pregnancy results in impaired safety and functioning for 24 months after delivery for mother and child.

Author Information

College of Nursing and the Department of Research, Texas Woman's University, Houston, Texas; and the University of Alabama in Huntsville, Huntsville, Alabama

Corresponding author: Judith McFarlane, DrPH, FAAN, 6700 Fannin, Houston, TX 77030; e-mail: jmcfarlane@twu.edu.

Funded by The Houston Foundation.

Financial Disclosure The authors did not report any potential conflicts of interest.

© 2014 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.