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足月和早产婴儿中身体和非身体伴侣虐待及其他低出生体重风险因素:一项多民族病例对照研究

Physical and nonphysical partner abuse and other risk factors for low birth weight among full term and preterm babies: a multiethnic case-control study.

作者信息

Campbell J, Torres S, Ryan J, King C, Campbell D W, Stallings R Y, Fuchs S C

机构信息

School of Nursing, The Johns Hopkins University, Baltimore, MD 21205-2110, USA.

出版信息

Am J Epidemiol. 1999 Oct 1;150(7):714-26. doi: 10.1093/oxfordjournals.aje.a010074.

Abstract

This study sought to determine the risk of low birth weight from intimate partner abuse. The case-control design was used in a purposively ethnically stratified multisite sample of 1,004 women interviewed during the 72 hours after delivery between 1991 and 1996. Abuse was determined by the Index of Spouse Abuse and a modification of the Abuse Assessment Screen. Separate analyses were conducted for 252 full term and 326 preterm infants. The final multiple logistic regression models were constructed to determine relative risk for low birth weight after controlling for other complications of pregnancy. Physical and nonphysical abuse as determined by the Index of Spouse Abuse were both significant risk factors for low birth weight for the full term infants but not the preterm infants on a bivariate level. However, the risk estimates decreased in significance in the adjusted models. Although today's short delivery stays make it difficult to assess for abuse, it is necessary to screen for domestic violence at delivery, especially for women who may not have obtained prenatal care. The unadjusted significant risk for low birth weight that became nonsignificant when adjusted suggests that other abuse-related maternal health problems (notably low weight gain and poor obstetric history) are confounders (or mediators) that help to explain the relation between abuse and low birth weight in full term infants.

摘要

本研究旨在确定亲密伴侣虐待导致低出生体重的风险。采用病例对照设计,对1991年至1996年间分娩后72小时内接受访谈的1004名妇女进行了有目的的种族分层多地点抽样。虐待情况通过配偶虐待指数和虐待评估筛查的改良版来确定。对252名足月儿和326名早产儿分别进行了分析。构建了最终的多元逻辑回归模型,以确定在控制其他妊娠并发症后低出生体重的相对风险。配偶虐待指数所确定的身体虐待和非身体虐待在双变量水平上都是足月儿低出生体重的显著危险因素,但对早产儿则不然。然而,在调整后的模型中,风险估计的显著性降低。尽管如今分娩住院时间短使得难以评估虐待情况,但在分娩时筛查家庭暴力是必要的,特别是对于那些可能未接受产前护理的妇女。未调整时低出生体重的显著风险在调整后变得不显著,这表明其他与虐待相关的孕产妇健康问题(尤其是体重增加不足和不良产科病史)是混杂因素(或中介因素),有助于解释足月儿中虐待与低出生体重之间的关系。

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