Domestic violence, depression predictors of low birth weight infants among low-income mothers

ANN ARBOR, Mich.—Low-income women with mental health problems and a history of domestic abuse were 12 times as likely to give birth to a low birth weight child, a new University of Michigan and University of Pittsburgh study shows.

While the strongest impact on the child involved both factors, either factor increases the risk significantly. In this study of Michigan mothers, those who were physically abused had a 10-fold risk of having a low birth weight infant, and the risk was eight-fold if they had mental health conditions, such as post-traumatic stress disorder or depression.

Violence against women occurs in every socioeconomic level. This study’s analysis – combined with other research – suggests that violence occurring around the time of pregnancy is a significant predictor of adverse infant outcomes for women who already are at risk due to the problem of poverty, including food insufficiency, the researchers say.

“These findings indicate that professionals from domestic violence, mental health and maternity care services working together could potentially decrease the chance of a baby being born too small -- in addition to helping improve the safety, health and well-being of the mother-to-be,” said Julia Seng, the study’s co-author and research associate professor at the U-M Institute for Research on Women and Gender, School of Nursing, and Department of Obstetrics and Gynecology.

Researchers looked at how intimate partner violence, depression and post-traumatic stress affected low-income mothers and the weight outcomes after giving birth. They considered these factors after taking into account the effect on birth weight of other known risk factors, including being African-American, not having enough to eat, and using substances.

The data included responses from the 148 women who had had a baby within the past five years and participated in the Women’s Employment Study, a survey of welfare recipients in an urban Michigan county. Domestic violence in this analysis was defined as physical abuse. The mental health conditions were assessed by standard psychiatric diagnostic interviews.

Researchers compared groups of women who did and did not give birth to low birth weight infants based on demographic, material deprivation (such as food), risk behavior, mental health and intimate partner violence factors.

A high proportion of women had been abused (21 percent) or suffered depression (23.6 percent). Food insufficiency was the most common form of economic deprivation, with more than half (59.5 percent) of the women indicating that they did not have enough food to eat in their homes.

Health care and social work practitioners working with pregnant women must be aware of any intimate partner violence or mental health problems, the researchers noted.

“Given the interrelated risks of poverty, intimate partner violence and mental health problems, we need to increase access to services for low-income women to reduce the chances of low-birth weight,” said Richard Tolman, a professor in the School of Social Work, one of the principal investigators of the Women’s Employment Study, and study’s co-author. “If we succeed in that, we can prevent the health and educational problems that low-birth weight infants may experience later in life.”

The findings appear in the October issue of the Journal of Interpersonal Violence. U-M researchers wrote the paper with lead author Daniel Rosen and Gayle Mallinger, both of the University of Pittsburgh.