Martin S L, Mackie L, Kupper L L, Buescher P A, Moracco K E
Department of Maternal and Child Health, School of Public Health, CB 7400, University of North Carolina, Chapel Hill, NC 27599-7400, USA.
JAMA. 2001 Mar 28;285(12):1581-4. doi: 10.1001/jama.285.12.1581.
Clinicians who care for new mothers and infants need information concerning postpartum physical abuse of women as a foundation on which to develop appropriate clinical screening and intervention procedures. However, no previous population-based studies have been conducted of postpartum physical abuse.
To examine patterns of physical abuse before, during, and after pregnancy in a representative statewide sample of North Carolina women.
DESIGN, SETTING, AND PARTICIPANTS: Survey of participants in the North Carolina Pregnancy Risk Assessment Monitoring System (NC PRAMS). Of the 3542 women invited to participate in NC PRAMS between July 1, 1997, and December 31, 1998, 75% (n = 2648) responded.
Prevalence of physical abuse during the 12 months before pregnancy, during pregnancy, and after infant delivery; injuries and medical interventions resulting from postpartum abuse; and patterns of abuse over time in relation to sociodemographic characteristics and use of well-baby care.
The prevalence of abuse before pregnancy was 6.9% (95% confidence interval [CI], 5.6%-8.2%) compared with 6.1% (95% CI, 4.8%-7.4%) during pregnancy and 3.2% (95% CI, 2.3%-4.1%) during a mean postpartum period of 3.6 months. Abuse during a previous period was strongly predictive of later abuse. Most women who were abused after pregnancy (77%) were injured, but only 23% received medical treatment for their injuries. Virtually all abused and nonabused women used well-baby care; private physicians were the most common source of care. The mean number of well-baby care visits did not differ significantly by maternal patterns of abuse.
Since well-baby care use is similar for abused and nonabused mothers, pediatric practices may be important settings for screening women for violence.
照顾新妈妈和婴儿的临床医生需要有关产后妇女身体虐待的信息，以此作为制定适当临床筛查和干预程序的基础。然而，此前尚未有基于人群的产后身体虐待研究。
在北卡罗来纳州具有代表性的全州女性样本中，研究怀孕前、怀孕期间及产后的身体虐待模式。
设计、地点和参与者：对北卡罗来纳州妊娠风险评估监测系统（NC PRAMS）的参与者进行调查。在1997年7月1日至1998年12月31日期间受邀参加NC PRAMS的3542名女性中，75%（n = 2648）做出了回应。
怀孕前12个月、怀孕期间及婴儿出生后的身体虐待患病率；产后虐待导致的伤害和医疗干预；以及与社会人口学特征和婴儿保健利用情况相关的随时间变化的虐待模式。
怀孕前虐待的患病率为6.9%（95%置信区间[CI]，5.6% - 8.2%），怀孕期间为6.1%（95% CI，4.8% - 7.4%），产后平均3.6个月期间为3.2%（95% CI，2.3% - 4.1%）。前期遭受虐待强烈预示着后期会遭受虐待。大多数怀孕后受虐的女性（77%）受伤，但只有23%因伤接受了治疗。几乎所有受虐和未受虐的女性都利用了婴儿保健服务；私人医生是最常见的保健服务来源。受虐母亲和未受虐母亲的婴儿保健就诊平均次数没有显著差异。
由于受虐和未受虐母亲对婴儿保健服务的利用情况相似，儿科诊所可能是筛查女性是否遭受暴力的重要场所。
