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Violence during pregnancy and substance use.

H Amaro, L E Fried, H Cabral and B Zuckerman

Department of Pediatrics, School of Medicine, Boston University, MA 02118.

Violent incidents were assessed as part of a prospective study of 1,243 pregnant women. Participants were predominantly poor, urban, minority group women. Seven percent (n = 92) of women reported physical or sexual violence during pregnancy. Most of the women (94 percent) knew their assailant. Victims of violence were at greater risk of having a history of depression and attempted suicide, having more current depressive symptoms, reporting less happiness about being pregnant, and receiving less emotional support from others for the current pregnancy. Comparisons of victims and non-victims showed that victims were more likely to be users of alcohol and drugs. In addition, partners of victims were more likely to use marijuana and cocaine. When possible confounders were controlled using multivariable analyses, a woman's alcohol use during pregnancy and her partner's drug use were independently associated with an increased risk of being a victim of violence during pregnancy. Results of this study highlight the importance of assessing exposure to violence during prenatal care, especially among women who are heavy users of alcohol or drugs or whose partners use these substances.

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