Silverman Jay G, Decker Michele R, Reed Elizabeth, Raj Anita
Department of Society, Human Development and Health, Harvard School of Public Health, Boston, Massachusetts 02115, USA.
J Womens Health (Larchmt). 2006 Oct;15(8):934-40. doi: 10.1089/jwh.2006.15.934.
To assess associations of experiences of intimate partner violence (IPV) and breastfeeding behaviors among a large, population-based sample of U.S. women.
Data were collected from women giving birth to live infants in 26 U.S. states and participating in the 2000-2003 Pregnancy Risk Assessment Monitoring System (PRAMS) (n = 118,579). Logistic regression analyses were conducted to assess the relations of experiences of IPV in the year prior to and during pregnancy to initiation and early cessation of breastfeeding.
Approximately 1 in 17 (5.8%) women delivering liveborn infants reported IPV either during or in the year prior to pregnancy. In crude logistic regression analyses, women who reported IPV in the year prior to pregnancy but not during pregnancy (OR 1.45, CI 1.26- 1.66), IPV during pregnancy but not in the year prior to pregnancy (OR 1.35, CI 1.11-1.64), and women reporting experiencing IPV across both periods (OR 1.52, CI 1.34-1.72) were significantly less likely to breastfeed the infants born subsequent to this pregnancy. Similarly, women reporting IPV around the time of pregnancy who initiated breastfeeding were more likely to cease breastfeeding by 4 weeks postpartum (ORs 1.41-1.71). In analyses adjusted for demographics and current smoking, however, experiences of IPV did not relate to women's risk for either outcome.
Although other factors beyond experiences of IPV may better predict a woman's decision or ability to breastfeed, abused women are overrepresented among mothers who do not or prematurely cease to breastfeed and should be identified and referred to appropriate services.
在美国大量基于人群的女性样本中评估亲密伴侣暴力(IPV)经历与母乳喂养行为之间的关联。
数据收集自美国26个州分娩活产婴儿并参与2000 - 2003年妊娠风险评估监测系统(PRAMS)的女性(n = 118,579)。进行逻辑回归分析以评估妊娠前一年及孕期的IPV经历与母乳喂养开始及早期停止之间的关系。
分娩活产婴儿的女性中约1/17(5.8%)报告在孕期或妊娠前一年遭受过IPV。在粗略逻辑回归分析中,报告在妊娠前一年但非孕期遭受IPV的女性(比值比[OR] 1.45,置信区间[CI] 1.26 - 1.66)、孕期但非妊娠前一年遭受IPV的女性(OR 1.35,CI 1.11 - 1.64)以及在两个时期均报告遭受IPV的女性(OR 1.52,CI 1.34 - 1.72)母乳喂养此次妊娠后出生婴儿的可能性显著降低。同样,报告在孕期前后遭受IPV且开始母乳喂养的女性在产后4周更有可能停止母乳喂养(OR为1.41 - 1.71)。然而,在对人口统计学特征和当前吸烟情况进行调整的分析中,IPV经历与女性出现这两种结果的风险均无关联。
尽管IPV经历之外的其他因素可能更能预测女性母乳喂养的决定或能力,但在未进行母乳喂养或过早停止母乳喂养的母亲中,受虐女性的比例过高,应予以识别并转介至适当的服务机构。