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The importance of intimate partner violence in within-relationship and between-person risk for alcohol-exposed pregnancy.

BACKGROUND: Pre-conceptual prevention programs geared towards reducing alcohol-exposed pregnancy (AEP) typically emphasize behavioral change of alcohol use and birth control exclusively, but rarely consider other important AEP predictors that may affect behavioral change. Intimate partner violence (IPV) substantially relates to AEP and to AEP predictors, however, few studies have tested if IPV is a unique indicator of prospective AEP risk, as both a main effect and a contextual influence on alcohol use or birth control.

METHODS: Using Waves II and III of the National Longitudinal Study of Adolescent to Adult Health (Add Health), multilevel logistic regression models were estimated, in which IPV and birth control (both within-person and between-person) and adolescent alcohol use (between-person only) were examined as unique predictors of AEP compared to both non-pregnancy and non-AEP outcomes over up-to-5 sexual relationships. Interactions between within-person and between-person IPV, and birth control or alcohol use were also tested.

RESULTS: Within-person and between-person IPV significantly related to higher odds of AEP compared to non-pregnancy and non-AEP. Adolescent alcohol use had similarly increased odds for AEP when compared to non-pregnancy or non-AEP outcomes. Only between-person birth control use related to higher odds for AEP compared to non-pregnancy and non-AEP. Between-person IPV also moderated adolescent alcohol use on odds of AEP, such that infrequent adolescent drinkers had higher odds of AEP compared to non-pregnancy or non-AEP if they experienced IPV over their relationships.

CONCLUSIONS: IPV is a substantial predictor for AEP as both a direct influence within relationships (within-person) and between individuals (between-person). Intervention and prevention programs focused on reducing AEP may benefit from including IPV-specific curricula. This article is protected by copyright. All rights reserved.

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