Domestic Violence in Pregnant Trauma Patients: A Multicenter Analysis

Purpose

Domestic violence (DV) during pregnancy is associated with a higher incidence of obstetric complications. This study aimed to identify the injury profile and outcomes of pregnant trauma patients (PTPs) presenting after DV. We hypothesize that PTPs presenting after DV have a higher rate of fetal delivery (FD) and adverse maternal outcomes, compared to propensity-matched PTPs sustaining non-DV trauma.

Methods

PTPs ≥ 18 years old were included in this post-hoc analysis of a multicenter retrospective (2016–2021) study at 12 Level-I/II trauma centers. An unmatched and a 1:2 propensity-matched analyses of PTPs presenting with mechanisms involving and not involving DV were performed.

Results

From 950 patients, 70 (7.4%) PTPs presented after DV. The median age of PTPs presenting after DV was 26 years, the most common ethnicity was Hispanic (40%), and the most common mechanism and injury type were assault (85.7%) and abdominal injury (11.4%). PTPs presenting after DV had a higher rate of head injury (10% vs. 4.2%, p = 0.026). There was no difference in maternal complications and rate of FD (p > 0.05). These results did not change in the 1:2 propensity-matched analysis.

Conclusion

Our study found a higher rate of head injuries among PTPs presenting after DV compared to similarly matched PTPs presenting after non-DV trauma. However, no significant differences were observed in the rate of FD or maternal and fetal complications. Examining the effectiveness of universal screening for DV in the trauma setting and prenatal care may help optimize care delivery and support services for affected PTPs.