The Feto-Maternal Health Cost of Intimate Partner Violence Among Delivery-Related Discharges in the United States, 2002-2009

J Interpers Violence. 2016 Feb;31(3):444-64. doi: 10.1177/0886260514555869. Epub 2014 Nov 11.

Abstract

Our purpose was to estimate the national prevalence of intimate partner violence (IPV) among delivery-related discharges and to investigate its association with adverse feto-maternal birth outcomes and delivery-related cost. A retrospective cross-sectional analysis of delivery-related hospital discharges from 2002 to 2009 was conducted using the Nationwide Inpatient Sample (NIS). We used ICD-9-CM codes to identify IPV, covariates, and outcomes. Multivariable logistic regression modeling was used to calculate adjusted odds ratios (OR) and 95% confidence intervals (CI) for the associations between IPV and each outcome. Joinpoint regression was used for trend analysis. During the study period, 3,649 delivery-related discharges were diagnosed with IPV (11.2 per 100,000; 95% CI = [10.0, 12.4]). IPV diagnosis during delivery is associated with stillbirth (AOR = 4.12, 95% CI = [2.75, 6.17]), preterm birth (AOR = 1.97, 95% CI = [1.59, 2.44]), fetal death (AOR = 3.34, 95% CI = [1.99, 5.61]), infant with poor intrauterine growth (AOR = 1.55, 95% CI = [1.01, 2.40]), and increased inpatient hospital care cost (US$5,438.2 vs. US$4,080.1) per each discharge, incurring an additional cost of US$4,955,707 during the study period. IPV occurring during pregnancy has a significant health burden to both the mother and infant. Education about IPV; screening at periodic intervals, including during obstetric visits; and ongoing clinical care could help to reduce or eliminate adverse effects of pregnancy-related IPV. Preventing the lifelong consequences associated with IPV can have a positive effect on the overall health of all women and delivery-related health care cost.

Keywords: alcohol and drugs; child abuse; domestic violence; sexual abuse; violence.

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Female
  • Health Care Costs
  • Humans
  • Infant, Newborn
  • Intimate Partner Violence / economics*
  • Intimate Partner Violence / statistics & numerical data
  • Logistic Models
  • Patient Discharge / economics*
  • Patient Discharge / statistics & numerical data
  • Postnatal Care / economics*
  • Postnatal Care / statistics & numerical data
  • Pregnancy
  • Pregnancy Complications / economics*
  • Pregnancy Complications / epidemiology
  • Pregnancy Outcome / economics
  • Retrospective Studies
  • United States / epidemiology
  • Women's Health / economics
  • Young Adult