Elsevier

Obstetrics & Gynecology

Volume 100, Issue 4, October 2002, Pages 773-780
Obstetrics & Gynecology

Original research
Pregnancy-associated assault hospitalizations1 ,

https://doi.org/10.1016/S0029-7844(02)02183-XGet rights and content

Abstract

OBJECTIVE:

To determine the rate of pregnancy-associated hospitalized assaults in a multistate population and whether they have any increased assault risk versus nonpregnant counterparts.

METHODS:

An International Classification of Diseases, 9th Revision (ICD-9-CM) pregnancy and injury criterion was applied to 1997 statewide hospital discharge data from 19 states (52% of the female population age 15–49 years). Cases were classified as assault-related with and without pregnancy-associated diagnoses. Pregnancy-associated and all women were compared using demographic specific rate ratios and severity stratification.

RESULTS:

There were 7402 assault-related injuries among all women ages 15–49; 745 (10%) were pregnancy-associated. The incidence of assaults involving hospitalizations was 65 per 100,000 person-years for pregnant women versus 21 per 100,000 for all women (rate ratio 3.14; 95% confidence interval [CI] 2.04, 3.39). Pregnant women were younger (mean age 24.2 versus 30.8 years), their average length of stay was shorter (2.6 versus 4.0 days), their mean injury severity score was less (2.5 versus 4.9), and the median charge per stay was lower ($3351 versus $6775). Unadjusted age-specific rate ratios (pregnant versus all women) for assaults were significantly higher for younger women 15–19 (rate ratio 7.22; 95% CI 4.81, 8.38), but when restricted to cases with injury severity scores of at least 4, most differences in rate ratios disappeared, except in the youngest women.

CONCLUSION:

While pregnant women were more likely to be hospitalized for assaults, most of the increase is associated with their lower hospital admission threshold and increased rates of both pregnancy and assaults among young and nonwhite women. Practitioners should perhaps think of pregnant women more as a “sensitive” rather than a “high-risk” group.

Section snippets

Materials and methods

The study examined the hypothesis that the hospitalization rate for assault is higher among pregnant women than all women of reproductive age (ages 15–49), once controlled for age, race, and severity. Secondary aims included quantifying the prevalence of hospitalized assaults in a large population-based sample of pregnant women and comparing and contrasting the patterns of assault injury mechanisms, severity, demographics, and costs. This study was given expedited review and approved by the

Results

E-coding was 92% complete among women 15–49 years with an injury-related diagnosis. This left 137,887 resident women aged 15–49 discharged from nonrehabilitation hospitals with an acute injury diagnosis and a valid mechanism/intent E-code. There were 7402 assault-related discharges for a rate of 21 per 100,000 person-years. Pregnancy-associated cases made up 10.0% (745/7402) of all assaults to women aged 15–49.

Among injured females 15–49 years with a pregnancy-associated diagnosis, 14%

Discussion

This is the first study to address the prevalence and risk of pregnancy-associated hospitalized assaults in a large multistate population. Most other studies of assault and pregnancy have focused on small clinic or urban populations, often overrepresented by socially disadvantaged minorities. Because most severe injuries will be seen in hospitals, regardless of race and social class, this study provides more representative findings of the risk patterns for serious assaults among women of

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    This project was supported under award number 1998-WT-VX-0016 from the National Institute of Justice, Office of Justice Programs, US Department of Justice. Points of view in this document are those of the authors and do not necessarily reflect the official position of the US Department of Justice.

    1

    This work was based in part on methods pioneered by Jesse Greenblatt, Andrew Dannenberg, and Christopher Johnson. We gratefully acknowledge the assistance of Karen Zuri in coordinating the state data requests.

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