Intimate partner violence during pregnancy: victim or perpetrator? Does it make a difference?

OBJECTIVES To differentiate between forms of intimate partner violence (IPV) (victim only, perpetrator only, or participating in reciprocal violence) and examine risk profiles and pregnancy outcomes. DESIGN Prospective. SETTING Washington, DC, July 2001 to October 2003. SAMPLE A total of 1044 high-risk African-American pregnant women who participated in a randomised controlled trial to address IPV, depression, smoking and environmental tobacco smoke exposure. METHODS Multivariable linear and logistic regression. MAIN OUTCOME MEASURES Low and very low birthweight, preterm and very preterm birth. RESULTS Five percent of women were victims only, 12% were perpetrators only, 27% participated in reciprocal violence and 55% reported no IPV. Women reporting reciprocal violence in the past year were more likely to drink, use illicit drugs and experience environmental tobacco smoke exposure and were less likely to be very happy about their pregnancies. Women reporting any type of IPV were more likely to be depressed than those reporting no IPV. Women experiencing reciprocal violence reported the highest levels of depression. Women who were victims of IPV were more likely to give birth prematurely and deliver low-birthweight and very-low-birthweight infants. CONCLUSIONS We conclude that women were at highest risk for pregnancy risk factors when they participated in reciprocal violence and so might be at higher risk for long-term consequences, but women who were victims of IPV were more likely to show proximal negative outcomes like preterm birth and low birthweight infants. Different types of interventions may be needed for these two forms of IPV.