Domestic violence during pregnancy and risk of low birthweight and maternal complications: a prospective cohort study at Mulago Hospital, Uganda.
OBJECTIVE
To investigate whether domestic violence during pregnancy is a risk factor for antepartum hospitalization or low birthweight (LBW) delivery.


METHODS
A prospective cohort study was conducted in Mulago hospital, Kampala, Uganda, among 612 women recruited in the second pregnancy trimester and followed up to delivery, from May 2004 through July 2005. The exposure (physical, sexual or psychological violence during pregnancy) was assessed using the Abuse Assessment Screen. The relative and attributable risks of LBW and antepartum hospitalization were estimated using multivariate logistic regression analysis.


RESULTS
The 169 women [27.7% 95% CI (24.3-31.5%)] who reported domestic violence during pregnancy did not differ significantly from the unexposed regarding sociodemographic characteristics, but differed significantly (P < 0.05) regarding domicile variables (had less household decision-making power, more resided in extended families and more had unplanned pregnancy). They delivered babies with a mean birthweight 2647.5 +/- 604 g, on average 186 g [(95% CI 76-296); P = 0.001] lower than those unexposed. After adjusting for age, parity, number of living children, pregnancy planning, domicile and number of years in marriage, the relative risk (RR) of LBW delivery among women exposed to domestic violence was 3.78 (95% CI 2.86-5.00). Such women had a 37% higher risk of obstetric complications (such as hypertension, premature rupture of membranes and anaemia) that necessitated antepartum hospitalization [RR 1.37 (95% CI 1.01-1.84)].


CONCLUSIONS
In this pregnancy cohort, domestic violence during pregnancy was a risk factor for LBW delivery and antepartum hospitalization.
Kaye
Dan K
DK
Department of Obstetrics and Gynaecology, Makerere University Medical School, Kampala, Uganda. dankkaye@yahoo.com
Mirembe
Florence M
FM
Bantebya
Grace
G
Johansson
Annika
A
Ekstrom
Anna Mia
AM
D000293:Adolescent; D000328:Adult; D001724:Birth Weight; D003657:Decision Making; D017579:Domestic Violence; D005260:Female; D006760:Hospitalization; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008423:Maternal Age; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000209:etiology*; D011295:Prenatal Care; D011446:Prospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D014454:Uganda / Q000453:epidemiology