title: Intimate partner violence, substance use, and adverse neonatal outcomes among urban women.
abstract: OBJECTIVE
  To assess the prevalence of intimate partner violence, substance use, and their co-occurrence during pregnancy and to examine their associations with adverse neonatal outcomes.
  
  
  METHODS
  Between February 2009-February 2010, pregnant women receiving obstetrical care at 3 urban clinics were screened for intimate partner violence and substance use between 24-28 weeks gestation. A chart review was conducted upon delivery to assess for adverse neonatal outcomes of low birth weight, preterm birth, and small for gestational age (SGA).
  
  
  RESULTS
  Maternal and neonatal data were collected on 166 mothers and their neonates. Overall, 19% of the sample reported intimate partner violence during their pregnancies. Of the study's neonates, 41% had at least 1 adverse neonatal outcome. Nearly one-half of the mothers reported using at least 1 substance during pregnancy. Women experiencing intimate partner violence had a higher prevalence of marijuana use than their nonabused counterparts (P < .01). Experiencing intimate partner violence was associated with a 4-fold increase in having a SGA neonate (aOR = 4.00; 95% CI 1.58-9.97). Women who reported marijuana use had 5 times the odds of having a neonate classified as SGA (aOR = 5.16, 95% CI 2.24-11.89) or low birth weight (aOR 5.00; 95% CI 1.98-12.65).
  
  
  CONCLUSIONS
  The prevalence of intimate partner violence during pregnancy and substance use is high in urban mothers, the risks of which extend to their neonates. Pediatric providers are urged to routinely screen for both issues and recognize the impact of co-occurrence of these risk factors on poor neonatal and childhood outcomes.
authors.affiliation: School of Nursing, Johns Hopkins University, Baltimore, MD 21205, USA. jalhuse1@jhu.edu
authors.forename: Jeanne L
authors.initials: JL
authors.lastname: Alhusen
authors.forename: Marguerite B
authors.initials: MB
authors.lastname: Lucea
authors.forename: Linda
authors.initials: L
authors.lastname: Bullock
authors.forename: Phyllis
authors.initials: P
authors.lastname: Sharps
mesh_terms: D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D047928:Premature Birth / Q000453:epidemiology* / Q000209:etiology*; D015995:Prevalence; D011446:Prospective Studies; D012907:Smoking / Q000009:adverse effects*; D013179:Spouse Abuse / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000453:epidemiology*; D014504:Urban Health
keywords: HPA; Hypothalamic-pituitary-adrenal; LBW; Low birth weight; SGA; Small for gestational age