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Sandra L. Martin, PhD; Linda Mackie, BS; Lawrence L. Kupper, PhD; Paul A. Buescher, PhD; Kathryn E. Moracco, PhD

JAMA. 2001;285:1581-1584.

Context  Clinicians who care for new mothers and infants need information concerning postpartum physical abuse of women as a foundation on which to develop appropriate clinical screening and intervention procedures. However, no previous population-based studies have been conducted of postpartum physical abuse.

Objectives  To examine patterns of physical abuse before, during, and after pregnancy in a representative statewide sample of North Carolina women.

Design, Setting, and Participants  Survey of participants in the North Carolina Pregnancy Risk Assessment Monitoring System (NC PRAMS). Of the 3542 women invited to participate in NC PRAMS between July 1, 1997, and December 31, 1998, 75% (n = 2648) responded.

Main Outcome Measures  Prevalence of physical abuse during the 12 months before pregnancy, during pregnancy, and after infant delivery; injuries and medical interventions resulting from postpartum abuse; and patterns of abuse over time in relation to sociodemographic characteristics and use of well-baby care.

Results  The prevalence of abuse before pregnancy was 6.9% (95% confidence interval [CI], 5.6%-8.2%) compared with 6.1% (95% CI, 4.8%-7.4%) during pregnancy and 3.2% (95% CI, 2.3%-4.1%) during a mean postpartum period of 3.6 months. Abuse during a previous period was strongly predictive of later abuse. Most women who were abused after pregnancy (77%) were injured, but only 23% received medical treatment for their injuries. Virtually all abused and nonabused women used well-baby care; private physicians were the most common source of care. The mean number of well-baby care visits did not differ significantly by maternal patterns of abuse.

Conclusion  Since well-baby care use is similar for abused and nonabused mothers, pediatric practices may be important settings for screening women for violence.

Author Affiliations: Department of Maternal and Child Health, School of Public Health (Dr Martin), Department of Biostatistics (Ms Mackie and Dr Kupper), and Department of Health Behavior and Health Education and Injury Prevention Research Center (Dr Moracco), University of North Carolina, Chapel Hill; and the State Center for Health Statistics, Raleigh, NC (Dr Buescher).

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