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Maternal and neonatal outcomes of assaults during pregnancy.
Obstet Gynecol. 2005 Feb; 105(2):357-63.OG

Abstract

OBJECTIVE

To assess perinatal outcomes of women hospitalized for assault during pregnancy as a function of timing of delivery.

METHODS

A retrospective population-based study analyzing maternal discharge records linked to birth/death certificates in California from 1991 to 1999 was performed. International Classifications of Disease, Ninth Clinical Modification (ICD-9-CM) codes were used to identify injury types and outcomes. External causation codes identified assaults as the mechanism of the injuries. Injury Severity Scores were assessed. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated, and multivariate logistic regression was used for analysis of outcomes.

RESULTS

A total of 2,070 women were hospitalized during pregnancy after sustaining an assault. Assaulted women were younger, multiparous, and with delayed prenatal care compared with unassaulted controls. Women delivering at the assault hospitalization had high rates of prematurity: 24%, OR 2.4 (95% CI 1.8-3.3), maternal death: 0.71%, OR 19 (95% CI 2.7-144.7), fetal death: 9.3%, OR 8 (95% CI 4.6-14.3), uterine rupture: 0.71%, OR 46 (95% CI 6.5-337.8), and other adverse outcomes compared with unassaulted women. Women discharged after an assault, delivering at a subsequent hospitalization, had increased risks of abruption: 2%, OR 1.8 (95% CI 1.3-2.5), hemorrhage: 3.2%, OR 1.8 (95% CI 1.4-2.5), prematurity: 15%, OR 1.3 (95% CI 1.2-1.5), and low birth weight: 13.4%, OR 1.7 (95% CI 1.5-1.9) at delivery.

CONCLUSION

Women sustaining an assault during pregnancy experience both immediate (uterine rupture, increased fetal and maternal mortality) and long-term sequelae (prematurity and low birth weight infants), which have significant negative effects on pregnancy outcome.

LEVEL OF EVIDENCE

III.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, University of California-Davis, 4860 Y Street, Sacramento, CA 95817, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15684165

Citation

El Kady, Dina, et al. "Maternal and Neonatal Outcomes of Assaults During Pregnancy." Obstetrics and Gynecology, vol. 105, no. 2, 2005, pp. 357-63.
El Kady D, Gilbert WM, Xing G, et al. Maternal and neonatal outcomes of assaults during pregnancy. Obstet Gynecol. 2005;105(2):357-63.
El Kady, D., Gilbert, W. M., Xing, G., & Smith, L. H. (2005). Maternal and neonatal outcomes of assaults during pregnancy. Obstetrics and Gynecology, 105(2), 357-63.
El Kady D, et al. Maternal and Neonatal Outcomes of Assaults During Pregnancy. Obstet Gynecol. 2005;105(2):357-63. PubMed PMID: 15684165.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Maternal and neonatal outcomes of assaults during pregnancy. AU - El Kady,Dina, AU - Gilbert,William M, AU - Xing,Guibo, AU - Smith,Lloyd H, PY - 2005/2/3/pubmed PY - 2005/3/11/medline PY - 2005/2/3/entrez SP - 357 EP - 63 JF - Obstetrics and gynecology JO - Obstet Gynecol VL - 105 IS - 2 N2 - OBJECTIVE: To assess perinatal outcomes of women hospitalized for assault during pregnancy as a function of timing of delivery. METHODS: A retrospective population-based study analyzing maternal discharge records linked to birth/death certificates in California from 1991 to 1999 was performed. International Classifications of Disease, Ninth Clinical Modification (ICD-9-CM) codes were used to identify injury types and outcomes. External causation codes identified assaults as the mechanism of the injuries. Injury Severity Scores were assessed. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated, and multivariate logistic regression was used for analysis of outcomes. RESULTS: A total of 2,070 women were hospitalized during pregnancy after sustaining an assault. Assaulted women were younger, multiparous, and with delayed prenatal care compared with unassaulted controls. Women delivering at the assault hospitalization had high rates of prematurity: 24%, OR 2.4 (95% CI 1.8-3.3), maternal death: 0.71%, OR 19 (95% CI 2.7-144.7), fetal death: 9.3%, OR 8 (95% CI 4.6-14.3), uterine rupture: 0.71%, OR 46 (95% CI 6.5-337.8), and other adverse outcomes compared with unassaulted women. Women discharged after an assault, delivering at a subsequent hospitalization, had increased risks of abruption: 2%, OR 1.8 (95% CI 1.3-2.5), hemorrhage: 3.2%, OR 1.8 (95% CI 1.4-2.5), prematurity: 15%, OR 1.3 (95% CI 1.2-1.5), and low birth weight: 13.4%, OR 1.7 (95% CI 1.5-1.9) at delivery. CONCLUSION: Women sustaining an assault during pregnancy experience both immediate (uterine rupture, increased fetal and maternal mortality) and long-term sequelae (prematurity and low birth weight infants), which have significant negative effects on pregnancy outcome. LEVEL OF EVIDENCE: III. SN - 0029-7844 UR - https://www.unboundmedicine.com/medline/citation/15684165/Maternal_and_neonatal_outcomes_of_assaults_during_pregnancy_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=15684165.ui DB - PRIME DP - Unbound Medicine ER -