title: The interrelationships between abuse, substance use, and psychosocial stress during pregnancy.
abstract: OBJECTIVE
  To describe the association between abuse during pregnancy and substance use and psychosocial stress.
  
  
  METHODS
  Prospective study of pregnant women.
  
  
  METHODS
  Urban prenatal clinics.
  
  
  METHODS
  1,937 predominately low-income, ethnically diverse women.
  
  
  METHODS
  Three questions from the Abuse Assessment Screen were used to measure abuse. For the total sample, 25.7% reported physical abuse in the past year, 10.5% physical abuse since pregnancy, and 4.5% sexual abuse in the past year. Adolescents were significantly more likely to report any abuse (37.6%) than were adults (22.6%) (chi-square = 44.94; df = 1; p < 0.001). White abused women were significantly more likely to report use of tobacco (chi-square = 17.34; df = 1; p < 0.001) and alcohol (chi-square = 5.65; df = 1, p < 0.01). Abused Asian women were more likely to smoke (chi-square = 12.13; df = 1, p < 0.001), as were women ethnically described as "other" (chi-square = 8.39; df = 1, p < 0.001). There was a higher, but not statistically significant, rate of substance use between abused and nonabused African-American, Native-American, and Hispanic women. Abused women of all races reported higher stress, less support from partners, less support from others, and lower self-esteem.
  
  
  CONCLUSIONS
  Abuse during pregnancy is associated with an increased incidence of substance use and psychosocial stress. These relationships must be incorporated into the clinical care of abused pregnant women.
authors.affiliation: School of Nursing, Oregon Health Sciences University, Portland 97201-3098, USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Curry
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D018585:Battered Women / Q000523:psychology / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D009773:Obstetric Nursing; D009922:Oregon; D011203:Poverty; D011247:Pregnancy; D011248:Pregnancy Complications / Q000208:ethnology / Q000523:psychology*; D011446:Prospective Studies; D012931:Social Environment; D013315:Stress, Psychological / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology