Correlates of Abuse Around the Time of Pregnancy: Results from a National Survey of Canadian Women

Dawn Kingston, Maureen Heaman, Marcelo Urquia, Patricia O’Campo, Patricia Janssen, Kellie Thiessen, Janet Smylie

Objectives Although several studies have examined risk factors associated with abuse during pregnancy or postpartum periods, many used clinic-based or small regional samples, and few were national or population-based, limiting their generalizability and clinical utility. The purpose of this study was to describe the correlates of abuse around the time of pregnancy among a nationally representative sample of women in Canada. Methods Using data from 6421 postpartum women (weighted n = 76,500) who completed the Canadian Maternity Experiences Survey from 10/2006 to 01/2007, we explored the association between demographic, psychosocial, behavioral, medical/obstetric factors and 'any' and 'severe' abuse. 'Any abuse' was defined as an affirmative answer to one or more of 10 items asked about physical or sexual abuse or threats of abuse. 'Severe abuse' was defined as experiencing a combination of threats and physical or sexual abuse. Odds ratios and their 95 % confidence intervals were generated from multivariable logistic regression models. Results 10.5 % of women (weighted n = 8400) reported 'any' abuse and 4.3 % (weighted n = 3400) reported 'severe' abuse in the previous 2 years. Correlates of severe abuse included: age <20 years; household income below the low income cut-off; single; stressful life events; history of depression or antidepressant use; smoking during pregnancy; and alcohol use prior to pregnancy. Correlates of 'any' abuse were the same as 'severe' abuse with the addition of age 20-34 years, developing a new health problem during pregnancy, and inadequate support during pregnancy. Increased odds of 'any' and 'severe' abuse were found for women who self-identified as Aboriginal and reduced odds of 'any' abuse were found among immigrant women and those who took folic acid pre-pregnancy. Conclusions We identified risk factors that may enhance early detection of abuse in the perinatal period, and inform the development of interventions and preventive strategies to address this important public health problem.