Intimate Partner Violence Around the Time of Pregnancy and Utilization of WIC Services
Intimate partner violence (IPV) around the time of pregnancy is a risk factor for adverse pregnancy and birth outcomes. The supplemental nutrition program for women, infants, and children (WIC), available to low income pregnant women, may provide an opportunity to identify victims of IPV and refer them to services. This cross-sectional study aims to determine whether WIC participants are more likely than non-WIC participants to have reported IPV before or during pregnancy in the United States.
The 2004–2011 National Pregnancy Risk Assessment Monitoring System (PRAMS) survey (n = 319,689) was analyzed in 2015. Self-reported WIC participation, pre-pregnancy IPV, and IPV during pregnancy were examined. The associations between IPV and WIC participation were analyzed using multiple logistic regression and adjusted odds ratios with corresponding 95% confidence intervals were calculated. Subpopulation analysis was conducted, stratified by race/ethnicity.
Nearly half of the study sample received WIC (48.1%), approximately 4% of women reported physical abuse 12 months before their most recent pregnancy, and 3% reported abuse during pregnancy. After adjusting for confounders, women who reported IPV before and during pregnancy had significantly higher odds of WIC utilization compared to women who did not report IPV. However, when stratified by race, the association was only significant for non-Hispanic White women (pre-pregnancy AOR 1.47, 95% CI [1.17, 1.85]; during pregnancy AOR 1.47, 95% CI [1.14, 1.88]).
Conclusions for Practice
There is an association between IPV before and during pregnancy and utilization of WIC. Public health professionals and policy makers should be aware of this association and use this opportunity to screen and address the needs of WIC recipients.
KeywordsViolence exposure Intimate partner violence The supplemental nutrition program for women, infants and children (WIC) Domestic violence Adverse birth outcome
The authors gratefully acknowledge the Pregnancy Risk Assessment Monitoring System (PRAMS) Working Group for the approval of data analyses. The PRAMS Working Group: Alabama—Izza Afgan, MPH; Alaska—Kathy Perham-Hester, MS, MPH; Arkansas—Mary McGehee, PhD; Colorado—Alyson Shupe, PhD; Connecticut—Jennifer Morin, MPH; Delaware—George Yocher, MS; Florida—Alisa Simon; Georgia—Qun Zheng, MS; Hawaii—Jihae Goo; Illinois—Patricia Kloppenburg, MT (ASCP), MPH; Iowa—Sarah Mauch, MPH; Louisiana—Megan O’Connor, MPH; Maine—Tom Patenaude, MPH; Maryland—vacant; Massachusetts—Emily Lu, MPH; Michigan—Peterson Haak; Minnesota—Mira Grice Sheff, PhD; Mississippi—Brenda Hughes, MPPA; Missouri—David McBride, PhD; Montana—JoAnn Dotson; Nebraska—Brenda Coufal; New Hampshire—David J. Laflamme, PhD, MPH; New Jersey—Lakota Kruse, MD; New Mexico—Oralia Flores; New York State—Anne Radigan; New York City—Candace Mulready-Ward, MPH; North Carolina—Kathleen Jones-Vessey, MS; North Dakota—Sandra Anseth; Ohio—Connie Geidenberger, PhD; Oklahoma—Alicia Lincoln, MSW, MSPH; Oregon—Claudia W. Bingham, MPH; Pennsylvania—Tony Norwood; Rhode Island—Karine Tolentino Monteiro, MPH; South Carolina—Mike Smith, MSPH; Texas—Tanya Guthrie, PhD; Tennessee—Ramona Lainhart, PhD; Utah—Nicole Stone; Vermont—Peggy Brozicevic; Virginia—Christopher Hill, MPH, CPH Washington—Linda Lohdefinck; West Virginia—Melissa Baker, MA; Wisconsin—Christopher Huard; Wyoming—Amy Spieker, MPH; CDC PRAMS Team, Applied Sciences Branch, Division of Reproductive Health
SWM developed the research question and designed the study. SWM and SSR developed the statistical analysis plan and SSR analyzed the data. All authors participated in reviewing and interpreting the results and contributed substantively to the writing of the manuscript.
No financial disclosures were reported by the authors of this paper.
Compliance with Ethical Standards
Conflict of interest
None of the authors have conflicts of interest to disclose.
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