The Feto-Maternal Health Cost of Intimate Partner Violence Among Delivery-Related Discharges in the United States, 2002-2009.
Our purpose was to estimate the national prevalence of intimate partner violence (IPV) among delivery-related discharges and to investigate its association with adverse feto-maternal birth outcomes and delivery-related cost. A retrospective cross-sectional analysis of delivery-related hospital discharges from 2002 to 2009 was conducted using the Nationwide Inpatient Sample (NIS). We used ICD-9-CM codes to identify IPV, covariates, and outcomes. Multivariable logistic regression modeling was used to calculate adjusted odds ratios (OR) and 95% confidence intervals (CI) for the associations between IPV and each outcome. Joinpoint regression was used for trend analysis. During the study period, 3,649 delivery-related discharges were diagnosed with IPV (11.2 per 100,000; 95% CI = [10.0, 12.4]). IPV diagnosis during delivery is associated with stillbirth (AOR = 4.12, 95% CI = [2.75, 6.17]), preterm birth (AOR = 1.97, 95% CI = [1.59, 2.44]), fetal death (AOR = 3.34, 95% CI = [1.99, 5.61]), infant with poor intrauterine growth (AOR = 1.55, 95% CI = [1.01, 2.40]), and increased inpatient hospital care cost (US$5,438.2 vs. US$4,080.1) per each discharge, incurring an additional cost of US$4,955,707 during the study period. IPV occurring during pregnancy has a significant health burden to both the mother and infant. Education about IPV; screening at periodic intervals, including during obstetric visits; and ongoing clinical care could help to reduce or eliminate adverse effects of pregnancy-related IPV. Preventing the lifelong consequences associated with IPV can have a positive effect on the overall health of all women and delivery-related health care cost.
Indiana University, Indianapolis, IN, USA mfmogos@iu.edu.
Mulubrhan F
MF
Mogos
University of South Florida, Tampa, FL, USA.
Winta N
WN
Araya
Virginia Commonwealth University, Richmond, VA, USA.
Saba W
SW
Masho
University of South Florida, Tampa, FL, USA.
Jason L
JL
Salemi
Indiana University, Indianapolis, IN, USA.
Carol
C
Shieh
University of South Florida, Tampa, FL, USA.
Hamisu M
HM
Salihu
D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007231:Infant, Newborn; D000066511:Intimate Partner Violence / Q000191:economics* / Q000706:statistics & numerical data; D016015:Logistic Models; D010351:Patient Discharge / Q000191:economics* / Q000706:statistics & numerical data; D011181:Postnatal Care / Q000191:economics* / Q000706:statistics & numerical data; D011247:Pregnancy; D011248:Pregnancy Complications / Q000191:economics* / Q000453:epidemiology; D011256:Pregnancy Outcome / Q000191:economics; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D016387:Women's Health / Q000191:economics; D055815:Young Adult
alcohol and drugs; child abuse; domestic violence; sexual abuse; violence