Sexual assault in pregnancy.

Area of Science:

• Obstetrics and Gynecology
• Forensic Medicine
• Public Health

Background:

• Limited data exists on the acute effects of sexual assault on pregnant individuals and their pregnancy outcomes.
• Sexual assault is a critical public health issue affecting diverse populations, including pregnant women.

Purpose of the Study:

• To analyze patient demographics, forensic evidence, and injury patterns in pregnant sexual assault victims.
• To compare pregnant victims with matched non-pregnant sexual assault victims.
• To compare pregnancy outcomes in assault victims with the general obstetric population.

Main Methods:

• Retrospective review of sexual assault cases in Dallas County from 1983-1988.
• Comparison of 114 pregnant victims with 114 matched non-pregnant victims.
• Analysis of injury patterns, forensic findings, and pregnancy outcomes.

Main Results:

• Pregnant victims were typically Black, parous, in their twenties, with a mean gestational age of 15 weeks and no prior prenatal care.
• Penetration sites (vulvar, oral, anal) and sperm detection rates were similar between pregnant and non-pregnant groups.
• Non-pregnant victims had higher rates of physical and genital trauma; pregnant victims showed no truncal injuries after 20 weeks gestation.

Conclusions:

• Sexual assault during pregnancy does not appear to increase the risk of spontaneous abortion or immediate delivery post-assault.
• Low birth weight (24%) and preterm delivery (16%) were common adverse pregnancy outcomes following sexual assault.
• Further research is needed to understand the long-term impacts on both mother and child.