Kearney Margaret H, Haggerty Lois A, Munro Barbara H, Hawkins Joellen W
William F. Connell School of Nursing, Boston College, 140 Commonwealth Ave., Chestnut Hill, MA 02467-3812, USA.
J Nurs Scholarsh. 2003;35(4):345-9. doi: 10.1111/j.1547-5069.2003.00345.x.
To compare the effects of recent intimate partner abuse on maternal and infant health in publicly versus privately insured pregnant women.
Exploratory descriptive analysis in 13 Massachusetts prenatal care sites from records of 2,052 women who had been screened during pregnancy for domestic violence.
Clinicians screened pregnant women for domestic violence using the Abuse Assessment Screen. After delivery, prenatal and birth outcome data and abuse screening results were extracted from medical records by project staff. Odds ratios were used to compare maternal and infant health indicators in abused and nonabused women. Data from women with public and private health insurance then were examined separately, using logistic regression to control for low education and single marital status while examining the odds of adverse maternal and infant outcomes in abused and nonabused women.
In the sample as a whole, recently abused women were more likely to be publicly insured and unmarried, to have less than 12 years of formal education, and to have medical and obstetrical complications. Parity, ethnic background, and infant birth outcomes did not differ in relation to abuse. In separate analyses for women with public and private health insurance, after controlling for marital status and education, abuse increased the odds of low infant Apgar scores, poor nutrition, hyperemesis, hypertension, and substance abuse in publicly insured women, and abuse increased the odds of poor nutrition and bleeding during pregnancy for privately insured women.
The different correlates of abuse in publicly and privately insured women might be important for clinicians caring for these different populations. Screening for abuse and providing abuse-related services are indicated for pregnant women.
比较近期亲密伴侣虐待对参加公共保险和私人保险的孕妇母婴健康的影响。
对马萨诸塞州13个产前护理点的2052名孕期接受过家庭暴力筛查的女性记录进行探索性描述性分析。
临床医生使用虐待评估筛查工具对孕妇进行家庭暴力筛查。分娩后，项目工作人员从医疗记录中提取产前和出生结局数据以及虐待筛查结果。采用比值比来比较受虐待和未受虐待女性的母婴健康指标。然后分别检查参加公共和私人医疗保险女性的数据，在检查受虐待和未受虐待女性母婴不良结局的几率时，使用逻辑回归来控制低教育水平和单身婚姻状况。
在整个样本中，近期受虐待的女性更有可能参加公共保险且未婚，接受的正规教育少于12年，并且有医疗和产科并发症。分娩次数、种族背景和婴儿出生结局与虐待情况无关。在对参加公共和私人医疗保险女性的单独分析中，在控制婚姻状况和教育水平后，虐待增加了参加公共保险女性婴儿阿氏评分低、营养不良、妊娠剧吐、高血压和药物滥用的几率，而虐待增加了参加私人保险女性孕期营养不良和出血的几率。
参加公共和私人保险女性中虐待情况的不同相关因素可能对照顾这些不同人群的临床医生很重要。建议对孕妇进行虐待筛查并提供与虐待相关的服务。
