Risk factors and health during pregnancy among women previously exposed to sexual violence

Objective To determine whether women exposed to sexual violence in adolescence or adulthood are at increased risk of adverse maternal characteristics during subsequent pregnancies. Design Register-based cohort study. Setting Iceland. Population We identified 586 women who attended a Rape Trauma Service (RTS) between 1993 and 2008 and all subsequent births of these women up to April 2011 (n = 915). These pregnancies were compared with 1641 randomly selected pregnancies of women who had not attended the RTS and who gave birth during the same calendar month. Methods Information on maternal smoking, body mass index and illicit drug use was obtained from maternal charts. We used Poisson regression to obtain multivariable adjusted relative risks (aRR) with 95% CI contrasting prevalence of outcomes in the two groups. Main outcome measures Characteristics and risk factors during pregnancy, including maternal smoking, body mass index, weight gain during pregnancy, illicit drug use. Results Compared with unexposed women, sexually assaulted women were younger and more often primiparous in subsequent pregnancy, more likely not to be employed (7.8% vs. 4.3%; aRR 2.42, 95% CI 1.49-3.94), not cohabiting (45.6% vs. 14.2%; aRR 2.15, 95% CI 1.75-2.65), smokers (45.4% vs. 13.5%; aRR 2.68, 95% CI 2.25-3.20), and more likely to have used illicit drugs during pregnancy (3.4% vs. 0.4%; aRR 6.27, 95% CI 2.13-18.43). Exposed primiparas were more likely to be obese (15.5% vs. 12.3%; aRR 1.56, 95% CI 1.15-2.12). Conclusions Women with a history of sexual violence are more likely to have risk factors during pregnancy that may affect maternal health and fetal development.