Physical injuries reported on hospital visits for assault during the pregnancy-associated period.
BACKGROUND
Violence is a recognized health risk to the mother, fetus, and infant during pregnancy and first-year postpartum (pregnancy-associated period). Although homicide is a leading cause of injury death among pregnant and postpartum women, the continuum of violence-related physical injuries that women sustain during this period has not been studied systematically.


OBJECTIVE
To describe the patterns of physical injuries reported on hospital visits for assault during pregnancy and the postpartum period for a population cohort of Massachusetts women.


METHODS
Using a retrospective cohort design with linked Massachusetts natality and hospital data from 2001 through 2005, 1,468 women (0.9%) who had 1,675 hospital visits (emergency department, observation, and inpatient) for assault were identified. Of these visits, 1,528 visits had at least one physical injury diagnostic code (800-999) from the International Classification of Disease, Ninth Edition, Clinical Modification (ICD-9 CM). Applying a modified Barell injury diagnosis matrix that uses the ICD-9 CM injury codes, the first physical injury noted for each visit was classified by body region and nature of injury. Then, the distributions of physical injuries by body region and nature of injury during pregnancy, postpartum, and overall pregnancy-associated periods are described. Also listed are those physical injuries reported in more than 5% of hospital visits for assault during either pregnancy or postpartum period.


RESULTS
Of the 1,528 hospital visits for assault with physical injury, the head and neck were the most frequently injured body regions overall (42.2%). The percentage of torso injuries during pregnancy was more than twice that in the postpartum period (21.5% vs. 8.7%). The leading physical injury during both pregnancy (25.4%) and the postpartum (23.1%) period was superficial or contusion to the head and neck. Other common injuries differed by period.


CONCLUSIONS
Patterns of physical injuries reported on hospital visits for assault for a population cohort provide information that could prove helpful in intervention programs.
Nannini
Angela
A
Bouvé College of Health Sciences, School of Nursing, Northeastern University, Boston, Massachusetts 02115-5000, USA. a.nannini@neu.edu
Lazar
Jane
J
Berg
Cynthia
C
Barger
Mary
M
Tomashek
Kay
K
Cabral
Howard
H
Barfield
Wanda
W
Kotelchuck
Milton
M
D000328:Adult; D000465:Algorithms; D004522:Educational Status; D005260:Female; D006753:Hospital Records / Q000706:statistics & numerical data*; D006801:Humans; D008404:Massachusetts / Q000453:epidemiology; D049590:Postpartum Period; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D014754:Violence / Q000145:classification / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000145:classification / Q000453:epidemiology*