title: Psychological and physical abuse among pregnant women in a Medicaid-sponsored prenatal program.
abstract: OBJECTIVE
  To document psychological and physical abuse during pregnancy among women enrolled in enhanced prenatal services (EPS); explore the associations between maternal risk factors and type of abuse; and examine the relationship between abuse and EPS participation.
  
  
  METHODS
  Cross-sectional study utilizing screening data collected between 2005 and 2008. Convenience sample of Medicaid-insured pregnant women enrolled in EPS selected from urban and rural providers.
  
  
  METHODS
  A prenatal screening tool that included measures such as Cohen's Perceived Stress Scale-4, Patient Health Questionnaire-2, and Abuse Assessment Screen was used.
  
  
  RESULTS
  Logistic regressions showed that high perceived stress and lack of father support were associated with all types of abuse and abuse history. Women with risk factors, such as a positive depression screen (odds ratio [OR]=2.36), were associated with psychological abuse but not with physical abuse during pregnancy. Less than a 12th-grade education was associated with physical abuse (OR=1.64) but not psychological abuse during pregnancy. The amount or the timing of EPS participation was not significantly associated with abuse history or abuse during pregnancy.
  
  
  CONCLUSIONS
  Risk factors, such as high perceived stress and lack of father support, may alert nurses to further explore abuse during pregnancy. Additional research is needed for understanding the relationship between abuse and EPS participation.
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Biology, College of Human Medicine, Michigan State University, Grand Rapids, Michigan 49503, USA. Jennifer.Raffo@hc.msu.edu
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Raffo
authors.forename: Cristian I
authors.initials: CI
authors.lastname: Meghea
authors.forename: Qi
authors.initials: Q
authors.lastname: Zhu
authors.forename: Lee Anne
authors.initials: LA
authors.lastname: Roman
mesh_terms: D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D017579:Domestic Violence / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007229:Infant Welfare; D007231:Infant, Newborn; D016015:Logistic Models; D008429:Maternal Welfare / Q000706:statistics & numerical data*; D008484:Medicaid / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D008824:Michigan / Q000453:epidemiology; D015999:Multivariate Analysis; D015997:Neonatal Screening / Q000379:methods*; D016017:Odds Ratio; D010465:Perception; D011247:Pregnancy; D011295:Prenatal Care / Q000379:methods*; D015995:Prevalence; D011594:Psychometrics; D018570:Risk Assessment; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D014481:United States