title: The impact of domestic violence and depressive symptoms on preterm birth in South India.
abstract: OBJECTIVE
  India has the highest absolute number of maternal deaths, preterm birth cases, and under-5 mortality in the world, as well as high domestic violence (DV) rates. We sought to examine the impact of DV and its psychosocial correlates on pregnancy and birth outcomes.
  
  
  METHODS
  Women seeking antenatal care in Tamil Nadu, South India (N = 150) were assessed during pregnancy, and birth outcomes were abstracted from medical records after the babies were born.
  
  
  RESULTS
  We found that psychological abuse (OR 3.9; 95% CI 1.19-12.82) and mild or greater depressive symptoms (OR 3.3; 95% CI 0.99-11.17) were significantly associated with increased risk of preterm birth. Physical abuse was also associated with increased risk of preterm birth, but this was not statistically significant (OR 1.9; 95% CI 0.59-6.19). In each of the above adjusted models, low maternal education was associated with increased risk of preterm birth, in the analysis with depressive symptoms OR 0.18, CI 0.04-0.86 and in the analyses with psychological abuse OR 0.19, CI 0.04-0.91.
  
  
  CONCLUSIONS
  These findings suggest that future research should focus on understanding the psychosocial antecedents to preterm birth, to better target interventions and improve maternal child health in limited resource settings.
authors.affiliation: Departments of Global Health, Psychiatry and Behavioral Sciences, University of Washington, Box 359931, 325 9th Ave, Seattle, WA, 98104, USA. deeparao@uw.edu.
authors.forename: Deepa
authors.initials: D
authors.lastname: Rao
authors.affiliation: Samarth, Chennai, India.
authors.forename: Shuba
authors.initials: S
authors.lastname: Kumar
authors.affiliation: Samarth, Chennai, India.
authors.forename: Rani
authors.initials: R
authors.lastname: Mohanraj
authors.affiliation: Departments of Global Health, Psychiatry and Behavioral Sciences, University of Washington, Box 359931, 325 9th Ave, Seattle, WA, 98104, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Frey
authors.affiliation: Departments of Epidemiology, Global Health, University of Washington, Seattle, WA, USA.
authors.forename: Lisa E
authors.initials: LE
authors.lastname: Manhart
authors.affiliation: Departments of Global Health, Psychiatry and Behavioral Sciences, University of Washington, Box 359931, 325 9th Ave, Seattle, WA, 98104, USA.
authors.forename: Debra
authors.initials: D
authors.lastname: L Kaysen
mesh_terms: D000328:Adult; D003863:Depression / Q000453:epidemiology*; D017579:Domestic Violence / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007231:Infant, Newborn; D011247:Pregnancy; D047928:Premature Birth / Q000453:epidemiology*; D011295:Prenatal Care; D012307:Risk Factors; D055815:Young Adult
keywords: Depressive symptoms; Domestic violence; India; Perinatal depression; Preterm birth