Kearney Margaret H, Munro Barbara Hazard, Kelly Ursula, Hawkins Joellen W
William F Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts 02467-3812, USA.
Nurs Res. 2004 Jan-Feb;53(1):36-45. doi: 10.1097/00006199-200401000-00006.
Intimate partner abuse of pregnant women has been linked to the delivery of low-birth-weight infants. Also, abused pregnant women have reported a greater prevalence of substance abuse, poor nutrition, and demographic risk factors for poor birth outcomes. These factors may play a role in the reported relation between intimate partner violence and birth weight.
To explore the role of substance abuse (smoking, alcohol, and drug use) and weight gain of less than 15 pounds during pregnancy as potential mediators of the relation between recent partner abuse and infant birth weight, and to investigate the role of demographic risk factors as potential moderators for the impact of abuse on birth weight.
Data were extracted on abuse screening results, demographics, birth outcomes, and a range of medical and obstetric risks and complications from the medical records of 1969 women who had been screened by clinicians for domestic abuse during pregnancy. Hypotheses were tested using multiple regression analysis.
Recent physical or psychological abuse had a small but significant effect on birth weight in this sample. Smoking and low weight gain were weak but significant mediators of the relation between recent abuse and infant birth weight. Single marital status was the strongest demographic predictor of decreased birth weight. No moderator effects were found.
Although prospective studies are warranted, nursing care to reduce smoking and promote adequate weight gain in all women along with support for women's efforts to seek safety from abuse may help to improve birth outcomes and promote maternal well-being.
亲密伴侣对孕妇的虐待与低体重儿的出生有关。此外，受虐待的孕妇报告称药物滥用、营养不良以及出生结局不佳的人口统计学风险因素更为普遍。这些因素可能在亲密伴侣暴力与出生体重之间的既定关系中发挥作用。
探讨药物滥用（吸烟、酗酒和吸毒）以及孕期体重增加不足15磅作为近期伴侣虐待与婴儿出生体重之间关系的潜在中介因素的作用，并调查人口统计学风险因素作为虐待对出生体重影响的潜在调节因素的作用。
从1969名在孕期接受临床医生家庭暴力筛查的女性的病历中提取关于虐待筛查结果、人口统计学、出生结局以及一系列医疗和产科风险及并发症的数据。使用多元回归分析对假设进行检验。
在这个样本中，近期的身体或心理虐待对出生体重有微小但显著的影响。吸烟和低体重增加是近期虐待与婴儿出生体重之间关系的微弱但显著的中介因素。单身婚姻状况是出生体重降低最强的人口统计学预测因素。未发现调节作用。
尽管有必要进行前瞻性研究，但护理工作应致力于减少所有女性的吸烟行为并促进其充分增重，同时支持女性寻求免受虐待的安全环境，这可能有助于改善出生结局并促进孕产妇健康。
