title: Sexual violence and neonatal outcomes: a Norwegian population-based cohort study.
abstract: OBJECTIVE
  The objective of this study was to explore the association between sexual violence and neonatal outcomes.
  
  
  METHODS
  National cohort study.
  
  
  METHODS
  Women were recruited to the Norwegian Mother and Child Cohort Study (MoBa) while attending routine ultrasound examinations from 1999 to 2008.
  
  
  METHODS
  A total of 76 870 pregnant women.
  
  
  METHODS
  Sexual violence and maternal characteristics were self-reported in postal questionnaires during pregnancy. Neonatal outcomes were retrieved from the Medical Birth Registry of Norway (MBRN). Risk estimations were performed with linear and logistic regression analysis.
  
  
  METHODS
  gestational age at birth, birth weight, preterm birth (PTB), low birth weight (LBW) and small for gestational age (SGA).
  
  
  RESULTS
  Of 76 870 women, 18.4% reported a history of sexual violence. A total of 4.7% delivered prematurely, 2.7% had children with a birth weight <2500 g and 8.1% children were small for their gestational age. Women reporting moderate or severe sexual violence (rape) had a significantly reduced gestational length (2 days) when the birth was provider-initiated in an analysis adjusted for age, parity, education, smoking, body mass index and mental distress. Those exposed to severe sexual violence had a significantly reduced gestational length of 0.51 days with a spontaneous start of birth. Crude estimates showed that severe sexual violence was associated with PTB, LBW and SGA. When controlling for the aforementioned sociodemographic and behavioural factors, the association was no longer significant.
  
  
  CONCLUSIONS
  Sexual violence was not associated with adverse neonatal outcomes. Moderate and severe violence had a small but significant effect on gestational age; however, the clinical influence of this finding is most likely limited. Women exposed to sexual violence in this study reported more of the sociodemographic and behavioural factors associated with PTB, LBW and SGA compared with non-abused women.
authors.affiliation: Section of Obstetrics, Department for Women's and Children's Health, Oslo University Hospital, Oslo, Norway.
authors.forename: Lena
authors.initials: L
authors.lastname: Henriksen
authors.affiliation: Department of Public Health and General Practice, Faculty of Medicine, The Norwegian University of Science and Technology (NTNU), Trondheim, Norway.|Department of Obstetrics and Gynecology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
authors.forename: Berit
authors.initials: B
authors.lastname: Schei
authors.affiliation: Department for Women's and Children's Health, National Resource Centre for Women's Health, Oslo University Hospital, Oslo, Norway.
authors.forename: Siri
authors.initials: S
authors.lastname: Vangen
authors.affiliation: Department of Health, Nutrition and Management, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway.
authors.forename: Mirjam
authors.identifier: http://orcid.org/0000-0002-9873-4023
authors.initials: M
authors.lastname: Lukasse
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D009664:Norway; D047928:Premature Birth; D012742:Sex Offenses; D055815:Young Adult
keywords: EPIDEMIOLOGY