Health behaviors as mediators for the effect of partner abuse on infant birth weight.
BACKGROUND
Intimate partner abuse of pregnant women has been linked to the delivery of low-birth-weight infants. Also, abused pregnant women have reported a greater prevalence of substance abuse, poor nutrition, and demographic risk factors for poor birth outcomes. These factors may play a role in the reported relation between intimate partner violence and birth weight.


OBJECTIVE
To explore the role of substance abuse (smoking, alcohol, and drug use) and weight gain of less than 15 pounds during pregnancy as potential mediators of the relation between recent partner abuse and infant birth weight, and to investigate the role of demographic risk factors as potential moderators for the impact of abuse on birth weight.


METHODS
Data were extracted on abuse screening results, demographics, birth outcomes, and a range of medical and obstetric risks and complications from the medical records of 1969 women who had been screened by clinicians for domestic abuse during pregnancy. Hypotheses were tested using multiple regression analysis.


RESULTS
Recent physical or psychological abuse had a small but significant effect on birth weight in this sample. Smoking and low weight gain were weak but significant mediators of the relation between recent abuse and infant birth weight. Single marital status was the strongest demographic predictor of decreased birth weight. No moderator effects were found.


CONCLUSIONS
Although prospective studies are warranted, nursing care to reduce smoking and promote adequate weight gain in all women along with support for women's efforts to seek safety from abuse may help to improve birth outcomes and promote maternal well-being.
Kearney
Margaret H
MH
William F Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts 02467-3812, USA. kearnema@bc.edu
Munro
Barbara Hazard
BH
Kelly
Ursula
U
Hawkins
Joellen W
JW
D000328:Adult; D018585:Battered Women / Q000523:psychology*; D001724:Birth Weight; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior; D006801:Humans; D017533:Marital Status; D008403:Mass Screening; D008404:Massachusetts / Q000453:epidemiology; D039382:Maternal Nutritional Physiological Phenomena; D015999:Multivariate Analysis; D009752:Nutritional Status; D011237:Predictive Value of Tests; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology*; D011256:Pregnancy Outcome; D015995:Prevalence; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D013179:Spouse Abuse / Q000517:prevention & control* / Q000523:psychology* / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000150:complications* / Q000453:epidemiology / Q000517:prevention & control / Q000523:psychology; D015430:Weight Gain