Effect of abuse during pregnancy on maternal and child safety and functioning for 24 months after delivery.
OBJECTIVE
To evaluate the long-term safety and functioning outcomes for abused women reporting abuse during pregnancy and their children's behavior compared with abused women who do not report abuse during pregnancy.


METHODS
Forty-six abused women seeking assistance for partner abuse and reporting being pregnant during the preceding 4 months were evaluated every 4 months for 24 months to compare levels of abuse, danger for murder, anxiety, depression, somatization, and posttraumatic stress disorder (PTSD) for abused women who report abuse during pregnancy (n=24) compared with abused women reporting abuse only outside of pregnancy (n=22). Internalizing and externalizing behavior scores were evaluated for the children.


RESULTS
At entry into the study, abused women reporting abuse during pregnancy reported significantly greater (P<.05) threats of abuse, sexual abuse, physical abuse, danger for murder, and PTSD compared with abused women not reporting abuse during pregnancy. Effect sizes were large. When evaluated over the course of 24 months after delivery, risk for murder remained higher for women reporting abuse during pregnancy for 8 months after delivery, depression was higher at 4, 8, 16, and 20 months after delivery, and PTSD was appreciably higher for 24 months. Children living with mothers abused during pregnancy displayed more behavioral problems for the entire 24-month period, especially problems of depression and anxiety.


CONCLUSIONS
The study documents the negative safety and function effects of abuse in pregnant women that remain for at least 24 months after delivery. This warrants incorporating abuse screening during the antenatal and postdelivery periods and a protocol of care during the antenatal period and beyond.
College of Nursing and the Department of Research, Texas Woman's University, Houston, Texas; and the University of Alabama in Huntsville, Huntsville, Alabama.
Judith
J
McFarlane
John
J
Maddoux
Sandra
S
Cesario
Anne
A
Koci
Fuqin
F
Liu
Heidi
H
Gilroy
Ann L
AL
Bianchi
D000328:Adult; D001007:Anxiety / Q000453:epidemiology; D002648:Child; D002669:Child Welfare; D003863:Depression / Q000453:epidemiology; D005260:Female; D006708:Homicide / Q000706:statistics & numerical data; D006801:Humans; D049590:Postpartum Period; D011247:Pregnancy; D011446:Prospective Studies; D018570:Risk Assessment; D013001:Somatoform Disorders / Q000453:epidemiology; D013179:Spouse Abuse; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology