The link between abuse during pregnancy and low birth weight

Abuse during pregnancy is considered a potentially modifiable risk factor for low birth weight (<2500 g). In this issue of the Canadian Medical Association Journal, Dr. Claire Murphy and colleagues report on their systematic review and meta-analysis designed to determine the strength of association between physical, sexual or emotional abuse during pregnancy and low birth weight. The issue is considered important because low birth weight �accounts for most neonatal mortality and contributes significantly to infant and childhood morbidity, as well as to rising health care costs.�

The authors used a fixed-effects model, which found that women who reported physical, sexual or emotional abuse during pregnancy were more likely than nonabused women to give birth to a baby with low birth weight (odds ratio 1.4, 95% confidence interval 1.1-1.8). The authors state that abuse may also increase the incidence of low birth weight indirectly by contributing to tobacco, drug and alcohol use.

Dr. Murhpy and colleagues conclude that society needs to strengthen the trend toward the assessment of psychosocial issues during pregnancy as a standard of care. In a related commentary, Dr. Jacquelyn Campbell states that action should begin now with further testing of an existing brochure-based intervention that can help health practitioners detect abuse during pregnancy.

Additional contacts: Dr. Jacquelyn Campbell, School of Nursing, Johns Hopkins University, Baltimore; tel: 410-955-2778, or email: [email protected].

Abuse: A risk factor for low birth weight? A systematic review and meta-analysis � C.C. Murphy et al. Abuse during pregnancy: a quintessential threat to maternal and child health � so when do we start to act? � J.C. Campbell