Intimate partner violence during pregnancy and adverse birth outcomes in Australia: A systematic review and meta-analysis

Background and Aim Intimate partner violence (IPV) during pregnancy is a serious public health concern with potential harm to mothers and newborns. This systematic review and meta-analysis synthesised Australian studies examining the association between IPV or family violence during pregnancy and preterm birth (PTB), low birth weight (LBW), small for gestational age (SGA), stillbirth (SB), and miscarriage. Methods English-language, peer-reviewed original studies conducted in Australia and reporting IPV during pregnancy as the exposure and at least one specified adverse birth outcome were sought from inception to March 2026 in Scopus, Medline, Emcare, Web of Science, and CINAHL. Two reviewers independently screened records at title, abstract, and full-text stages, with conflicts resolved by consensus. Adjusted odds ratios (AORs) and unadjusted odds ratios (ORs) were pooled using random-effects models. Quality was appraised with Joanna Briggs Institute tools, and heterogeneity, publication bias, and sensitivity analyses were assessed. Results Ten studies comprising 230,601 women met the inclusion criteria. The pooled prevalence of IPV during pregnancy was 7.20% (95% CI, 3.75, 13.37; I 2 = 99.9%, p < 0.001). IPV was significantly associated with preterm birth (AOR 1.30; 95% CI: 1.14, 1.48; I 2 = 29.7%, p = 0.171) and low birth weight (AOR 1.70; 95% CI: 1.07, 2.69; I 2 = 36%, p = 0.179). Higher but non-significant odds were observed for stillbirth (AOR 1.29; 95% CI: 0.21, 7.86; I 2 = 83.3%, p = 0.018) and SGA (AOR 1.37; 95% CI: 0.18, 10.43; I 2 = 92.2%, p < 0.001). One study reported an unadjusted association with miscarriage (OR 2.00; 95% CI: 1.55, 2.55). Conclusion IPV during pregnancy is associated with increased odds of adverse birth outcomes, significantly so for PTB and LBW, supporting routine antenatal IPV screening and integrated support within maternity care. Interpretation warrants caution given observational designs, few contributing studies, and substantial heterogeneity. Further Australian research is needed.