Does spousal abuse during pregnancy affect the infant birth weight?

Date of Award


Document Type


Degree Name

Master of Science in Epidemiology & Biostatistics (MSc Epidemiology & Biostats)


Community Health Sciences


Abuse by an intimate partner (also called domestic violence) is the most common form of violence against women. More recently, a significant attention is being paid to the intricacies of the relationship between pregnancy and abuse. Abuse during pregnancy can result not only in obstetric complications; but can also have serious implications for the health and the well being of the fetus or infant. This study sought to assess the risk of low birth weight from spousal abuse during pregnancy in Karachi, Pakistan. We performed a case control study comprising 250 women who delivered low birth weight (__2500 g) babies (cases) and 250 women with normal birth weight babies (control group). Data collection for the study was undertaken in the obstetric wards of four tertiary care hospitals of Karachi from 26th September till 24th December 2005. Abuse was determined by WHO Domestic Violence Module. Data were analyzed using appropriate descriptive analysis and multiple logistic regression analysis methods. Overall, nearly one third of the women (29.5% cases, 32% controls) reported physical abuse and half of the women in both the groups reported one or more act of emotional abuse in their married life. The prevalence of physical abuse during index pregnancy was nearly 12% in both the groups. Relatively more cases experienced emotional abuse during index pregnancy (Cases 44.8%, Controls 41.6%). The final multiple logistic regression model showed a significant association of maternal weight (OR 0.95; CI 0.93, 0.98), maternal anemia (OR 1.56; CI 1.01, 2.41) and premature rupture of membrane (PROM) (OR 4.26; CI 2.45, 7.39) with low birth weight. History of either physical or emotional abuse during index pregnancy was not significantly associated with low birth weight (OR 1.19; CI 0.80, 1.79). Abuse is more common during pregnancy than some well known conditions such as gestational diabetes and pregnancy induced hypertension for which women are routinely screened and evaluated. The high prevalence of abuse both in cases and controls is curtailing its significance as a risk factor for low birth weight; however this should not undermine its importance as a social ailment. It has important consequences on the physical, mental and social status of the women during pregnancy. We recommend including abuse as an integral part of the standardized screening for risk factors of adverse pregnancy outcome. Moreover we need to improve the nutritional status of the women and efficiently identify obstetric complications such as PROM in order to reduce the burden of low birth weight. We also need to explore the association of compromised nutritional status of mother and PROM with abuse.

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