IPV may also influence PTB risk through multiple indirect pathways. Victims of IPV may be less likely to access prenatal care, and may engage in unhealthy behaviors including increased alcohol consumption, cigarette smoking and illicit drug use. Support for this thesis comes from studies showing that abused pregnant women have significantly higher levels of stress and less support from partners than women who are not abused [21, 42, 43]. Available data also indicate strong associations between history of abuse with increased frequencies of unhealthy behaviors such as alcohol or drug use during pregnancy [44], and inadequate prenatal care or late entry to prenatal care [45, 46]. Additional studies are needed to disentangle the independent and joint effect of IPV exposure and these risk factors on PTB risk.