BATTERING IN PREGNANCY - AN ASSESSMENT OF 2 SCREENING METHODS

Objective: To compare two different screening techniques for identifyi ng women with a history of domestic violence or battering in the curre nt pregnancy. Methods: The five-question Abuse Assessment Screen was i ncorporated into routine social service interviews and applied prospec tively to all registrants for routine prenatal care at Women and Infan ts' Hospital during an initial social service evaluation from Septembe r 7 through October 29, 1993. This group (N = 143) was compared to a h istorical control group of all new registrants from July 12 through Se ptember 3, 1993 (N = 191) who had routine interviews by social service s. Demographic and medical data were compared, as well as the specific information addressed by the screen, including history of domestic vi olence, physical or sexual violence within the last year, violence dur ing the current pregnancy, recent sexual abuse, and fear of partner. R esults: The median age of the study population was 23 years old, 50% w ere white, 63% were single, and 42% had no insurance. There was a high er detection of violence in all categories using the Abuse Assessment Screen compared with the standard interview-any history: 41 versus 14% (relative risk [RR] 3.0, 95% confidence interval [CI] 2.0-4.5); recen t history: 15 versus 3% (RR 5.6, CI 2.2-14.5); during pregnancy: 10 ve rsus 1% (RR 9.3, CI 2.2-40.5); recent sexual abuse: 4 versus 0% (P = . 006); and fear of abuser: 6 versus 3% (RR 1.8, CI 0.6-5.0). Conclusion : Use of a structured screen improves detection rates of battering bot h before and during pregnancy, enabling clinicians to have a greater o pportunity to intervene.