Domestic violence during pregnancy doubles risk of preterm birth, low birth weight

Researchers from the University of Iowa analysed 50 studies into the effects of domestic violence by a partner or ex-partner on risk of preterm birth, low birth weight (less than 2500g) and small-for-gestational-age babies. The combined results evaluated more than 5 million women from 17 countries, 15,000 of whom had experienced domestic violence.

Overall, the results found that domestic violence doubled the risk of preterm birth and low birth weight. This risk was increased further for women who experienced two or more types of domestic violence during their pregnancy.

There were fewer studies which looked into the effect of domestic violence by a partner or ex-partner on the baby being small-for-gestational-age, however the results indicated a small increased risk.

Lead author, Audrey Saftlas, professor in Epidemiology at the University of Iowa said: "Domestic violence by a partner or ex-partner is of particular concern during pregnancy when not one, but two lives are at risk. Although rates of domestic violence differ across the world, the detrimental effects of abuse on pregnant women are very clear and we must continue to establish effective interventions globally in order to prevent violence and to support women who report abuse."

Domestic violence by a partner or ex-partner is one of the most common forms of violence against women and includes physical, sexual, financial, psychological or emotional abuse. In England and Wales, more than one in four women has experienced at least one incident of this type of domestic violence since the age of 16; approximately 1 million women a year experience at least one incident of domestic violence and two women a week are killed by their current or former partner.

Domestic violence by a partner or ex-partner can directly affect the growing fetus, through physical or sexual trauma, or indirectly due to increased maternal stress, inadequate nutrition and poor prenatal care.

Professor Lesley Regan, Vice President for Strategic Development for the Royal College of Obstetricians and Gynaecologists (RCOG), said: "Domestic violence during pregnancy can have fatal or long term consequences for both mother and baby. These pregnant women have very complex needs and do not necessarily know about the support that is available to them.

"Healthcare professionals have an important role to play in tackling the problem and are often the first and only point of contact that the isolated and vulnerable victim reaches out to. All of us working in health and social services need to be trained to recognise the signs of domestic violence and abuse and know how to act and who to refer to, to ensure the woman's safety."

Professor John Thorp, Deputy Editor-in-chief of BJOG said: "This is a strong study bringing together data from around the world. While it provides robust evidence about the association between domestic violence by a partner or ex-partner, violence during pregnancy and adverse infant outcomes, further research is needed to understand the biological mechanism behind this link, as well as addressing the effectiveness of interventions to prevent domestic violence during pregnancy."