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Am J Perinatol 2025; 42(10): 1325-1332
DOI: 10.1055/a-2491-4269
Original Article

Social Determinants of Health Associated with Intimate Partner Violence in an Urban Obstetric Population

Christina R. Kuhrau 
1   Department of Obstetrics and Gynecology, University of Cincinnati Medical Center, Cincinnati, Ohio
,
Elizabeth Kelly
1   Department of Obstetrics and Gynecology, University of Cincinnati Medical Center, Cincinnati, Ohio
2   Perinatal Institute, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
,
Emily A. DeFranco
1   Department of Obstetrics and Gynecology, University of Cincinnati Medical Center, Cincinnati, Ohio
› Author Affiliations
Funding This study was funded by the NIH-University of Cincinnati Medical Student Summer Research Program (grant no.: T35DK060444)
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Abstract

Objective

Intimate partner violence (IPV) is pervasive and can lead to severe health consequences. In the United States, 25% of women have experienced sexual violence, physical violence, and/or stalking by an intimate partner. However, less is known about the frequency and risk factors for IPV in the obstetric population.

Study Design

Nested case–control study from a prospective cohort study of 606 parturients at a single academic medical center from 2011 to 2022. Structured questionnaires were administered to randomly chosen, consented patients during their postpartum hospital stay to gather information on social determinants of health (SDoH) and birth outcomes. The case group included participants who reported forced sex causing pregnancy, verbal abuse before or during pregnancy, or physical abuse during pregnancy. The control group reported none of these. Odds ratios were used to quantify the relationship between IPV and maternal sociodemographic characteristics, pregnancy factors, and levels of perceived support and discrimination.

Results

Of 606 study participants, 568 (94%) provided data on IPV. Of those, 20.4% reported IPV (case) and 80.6% reported no IPV (control). In total, 74.6% of the study population was enrolled prepandemic. Unmarried status, low income, food insecurity, housing insecurity, substance use during pregnancy, higher gravidity, unintended pregnancy, low social support, and racial and gender discrimination were all significantly associated with IPV; maternal race and pregnancy during the COVID-19 pandemic were not.

Conclusion

IPV is common, reported by one in five parturients in our population. Although maternal race was not associated with IPV in this perinatal cohort, experiencing racism was. Initiatives aimed to address SDoH such as substance use, family planning, and access to food and housing remain key opportunities to support pregnant patients experiencing IPV. The connection between perceived discrimination and IPV found here highlights the importance of addressing the influence of racism and gender-based discrimination on adverse birth outcomes in the United States.

Key Points

  • One in five parturients disclosed IPV.

  • Racial discrimination was correlated with IPV.

  • Food and housing insecurity increase IPV risk.

  • COVID-19 did not increase the rate of IPV.

  • Psychosocial support is vital during pregnancy.

Keywords

COVID-19 - discrimination - intimate partner violence - IPV - pandemic - perinatal - pregnancy - racism

Supplementary Material



Publication History

Received: 26 August 2024

Accepted: 28 November 2024

Accepted Manuscript online:
29 November 2024

Article published online:
28 December 2024

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