title: Intimate partner violence during pregnancy: incidence and associated health behaviors in a rural population.
abstract: OBJECTIVE
  The goal of this investigation was to examine the prevalence of different types of intimate partner violence (IPV) during pregnancy, as well as the association between both physical and psychological IPV and negative health behaviors, including smoking, other substance use, inadequate prenatal care utilization, and nutrition, in a rural sample.
  
  
  METHODS
  104 southern Appalachian women, primarily Caucasian and lower SES, completed a pregnancy interview focused on IPV (CTS2) and health behaviors. Medical records were also reviewed.
  
  
  RESULTS
  81% of participants reported some type of IPV during the current pregnancy, with 28% reporting physical IPV, and 20% reporting sexual violence. More than half were current smokers. Physical IPV during pregnancy was associated with significantly increased rates of pregnancy smoking (including decreased rates of quitting and reducing), increased rates of alcohol, marijuana, and harder illicit drug use around the time of conception, and later entry into prenatal care. The experience of psychological IPV during pregnancy was associated with a significantly decreased likelihood of quitting or reducing smoking during pregnancy, an increased rate of alcohol use around the time of conception, and an increased rate of pre-pregnancy obesity.
  
  
  CONCLUSIONS
  In this sample, pregnancy IPV and smoking occurred at rates well above national averages. Additionally, while physical IPV during pregnancy was associated with several negative pregnancy health behaviors, the experience of psychological IPV, even in the absence of physical IPV, also placed women at increased risk for negative health behaviors, all of which have been linked to poor pregnancy and newborn outcomes.
authors.affiliation: Department of Family Medicine, James H. Quillen College of Medicine, East Tennessee State University, P.O. Box 70621, Johnson City, TN 37614, USA. nordstro@mail.etsu.edu
authors.forename: Beth A
authors.initials: BA
authors.lastname: Bailey
authors.forename: Ruth Ann
authors.initials: RA
authors.lastname: Daugherty
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology; D018585:Battered Women / Q000706:statistics & numerical data; D019548:Crime Victims / Q000523:psychology / Q000706:statistics & numerical data; D017579:Domestic Violence; D005260:Female; D015438:Health Behavior; D006801:Humans; D015994:Incidence; D008429:Maternal Welfare; D011247:Pregnancy; D011314:Preventive Health Services / Q000706:statistics & numerical data; D012307:Risk Factors; D012424:Rural Population; D012907:Smoking / Q000453:epidemiology; D013179:Spouse Abuse / Q000523:psychology / Q000706:statistics & numerical data*; D018454:Spouses; D013714:Tennessee / Q000453:epidemiology