Physical Abuse of Women and Pregnancy Outcomes: A Systematic Review and Meta-Analyses

Abstract

Background: Physical abuse of women of childbearing age has been suggested as a precursor for infant being born LBW, PTB or SGA. Postulated mechanisms for adverse outcome among abused women include psychological stress, actual physical trauma leading to abruption of placenta, adoption of risky behaviours and unintended pregnancies. Objective(s): Systematically review the risk of infant being LBW/PTB/ SGA among mothers who had history of physical abuse prior to or during pregnancy. Design/Methods: Medline, Embase, CINAHL, and bibliographies of identified articles were searched for English language studies reporting on physical abuse and pregnancy outcomes. Quality of the studies was assessed based on criteria for sample selection, exposure assessment, confounder, analytical, outcome assessment and attrition biases. Meta-analyses were performed using random effect model and unadjusted odds ratio, adjusted odds ratio and 95% confidence interval were calculated. Criteria of MOOSE statement were followed. Result(s): Thirty studies were included. Most of them had moderate risk of bias due to lack of adjustment of confounders. Results of meta-analyses are reported below. Conclusion(s): Physical abuse of women of child-bearing age is associated with a significantly increased risk of LBW and PTB. Identification of at risk women during antenatal assessment should become a mandatory step to improve maternal and infant outcomes. (Table presented).