Bair-Merritt Megan H, Blackstone Mercedes, Feudtner Chris
Pediatric Generalist Research Group, Division of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA.
Pediatrics. 2006 Feb;117(2):e278-90. doi: 10.1542/peds.2005-1473.
Children exposed to intimate partner violence (IPV) are at increased risk for adverse mental and behavioral health sequelae, as has been documented by both systematic reviews and meta-analyses. Studies addressing the physical health impact of childhood IPV exposure, however, have not been summarized in a manner that might facilitate additional hypothesis-driven research and accelerate the development of targeted interventions.
To identify a comprehensive set of articles examining the association between childhood IPV exposure and physical health, we searched online bibliographic databases including Medline, CINAHL, PsychInfo, and Sociological Abstracts using the keywords "domestic" or "intimate partner violence" and "infant," "child," or "pediatric." From >2000 articles retrieved in the initial search, we used online abstract and bibliographic information to identify 94 articles potentially meeting the inclusion criteria of studies that (1) examined a postnatal physical health outcome related to IPV exposure and (2) had a contemporaneous control group. Thorough review of these 94 published studies yielded 22 that met these inclusion criteria. The data then were abstracted independently by 2 of the authors, and differences were settled with the assistance of a third author.
Childhood exposure to IPV increases the likelihood of risk-taking behaviors during adolescence and adulthood and is likely associated with underimmunization. Minimal data and study limitations preclude establishing a clear connection between IPV exposure and general health and use of health services, breastfeeding, or weight gain.
The impact on physical health from exposure to IPV during childhood is still uncertain. Future studies should be grounded in a theoretical model that specifies how IPV exposure can affect child health, should adjust for confounders adequately, should include a community-based sample, and should be of larger scale.
系统评价和荟萃分析均已证明，遭受亲密伴侣暴力（IPV）的儿童出现不良心理和行为健康后遗症的风险增加。然而，针对童年期遭受IPV对身体健康影响的研究尚未以有助于开展更多假设驱动型研究并加速针对性干预措施发展的方式进行总结。
为了确定一组全面的文章，以研究童年期遭受IPV与身体健康之间的关联，我们使用关键词“家庭”或“亲密伴侣暴力”以及“婴儿”“儿童”或“儿科”，在包括Medline、CINAHL、PsychInfo和Sociological Abstracts在内的在线书目数据库中进行搜索。在初步搜索中检索到的2000多篇文章中，我们利用在线摘要和书目信息确定了94篇可能符合纳入标准的文章，这些研究需满足：（1）研究与遭受IPV相关的产后身体健康结果；（2）有同期对照组。对这94篇已发表研究进行全面审查后，有22篇符合这些纳入标准。然后由两位作者独立提取数据，如有分歧则在第三位作者的协助下解决。
童年期遭受IPV会增加青少年期和成年期冒险行为的可能性，并且可能与免疫接种不足有关。由于数据有限和研究存在局限性，无法明确建立IPV暴露与总体健康、医疗服务利用、母乳喂养或体重增加之间的联系。
童年期遭受IPV对身体健康的影响仍不确定。未来的研究应以理论模型为基础，该模型应明确IPV暴露如何影响儿童健康，应充分调整混杂因素，应纳入基于社区的样本，并且规模应更大。
