title: Violence and adverse pregnancy outcomes: a review of the literature and directions for future research.
abstract: BACKGROUND
  Violence during pregnancy has been estimated to affect between 0.9% and 20.1% of pregnant women in the United States. This article presents a review of the research on the potential association between violence during pregnancy and adverse outcomes, explores mechanisms by which violence might influence pregnancy outcomes, and suggests directions for future research aimed at the development of successful interventions.
  
  
  METHODS
  A review of the literature pertaining to violence during pregnancy and adverse pregnancy outcomes, trauma, and stress during pregnancy was completed.
  
  
  RESULTS
  Overall, no pregnancy outcome was consistently found to be associated with violence during pregnancy. The trauma literature offers insight about the effects that injuries caused by physical violence might have on pregnancy outcomes. Information from the stress literature investigates potential mechanisms through which physical violence could indirectly affect pregnancy outcomes. The trauma and stress literature offers methodologic approaches that could be employed in future research on violence during pregnancy and pregnancy outcomes.
  
  
  CONCLUSIONS
  This review lays the groundwork for the development of a future research agenda to investigate the association between violence during pregnancy and adverse outcomes. Future research should include quantitative and qualitative approaches, and investigation into the mechanisms and antecedents of how violence during pregnancy may lead to adverse outcomes. Only with such information can successful interventions to limit violence and its potential effects during pregnancy be implemented.
authors.affiliation: Department of Maternal and Child Health, School of Public Health, University of North Carolina, Chapel Hill, USA.
authors.forename: R
authors.initials: R
authors.lastname: Petersen
authors.forename: J A
authors.initials: JA
authors.lastname: Gazmararian
authors.forename: A M
authors.initials: AM
authors.lastname: Spitz
authors.forename: D L
authors.initials: DL
authors.lastname: Rowley
authors.forename: M M
authors.initials: MM
authors.lastname: Goodwin
authors.forename: L E
authors.initials: LE
authors.lastname: Saltzman
authors.forename: J S
authors.initials: JS
authors.lastname: Marks
mesh_terms: D015984:Causality; D015986:Confounding Factors, Epidemiologic; D017579:Domestic Violence / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000209:etiology; D011256:Pregnancy Outcome / Q000453:epidemiology*; D012107:Research Design; D013315:Stress, Psychological / Q000453:epidemiology; D014947:Wounds and Injuries / Q000453:epidemiology