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Pregnancy-Associated Assault Hospitalizations

From the Center for Injury Research and Control, University of Pittsburgh, Pittsburgh, Pennsylvania; and Pacific Institute for Research and Evaluation, Calverton, Maryland.

Address reprint requests to: Harold B. Weiss, PhD, MPH, Center for Injury Research and Control, Presbyterian University Hospital, Suite B-400, University of Pittsburgh, 200 Lothrop St., Pittsburgh, PA 15213; E-mail: hw{at}injurycontrol.com.

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

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