Sanchez Sixto E, Qiu Chunfang, Perales Maria T, Lam Nelly, Garcia Pedro, Williams Michelle A
Health Direction V Lima City, Jr. Antonio Raymondi 220, La Victoria, Lima, Peru.
Eur J Obstet Gynecol Reprod Biol. 2008 Mar;137(1):50-5. doi: 10.1016/j.ejogrb.2007.05.013. Epub 2007 Jun 27.
Mounting evidence supports the view that intimate partner violence (IPV) is an important cause of maternal mortality. Some, but not all, prior studies suggest that IPV is associated with increased risks of maternal medical conditions such as hypertensive disorders of pregnancy which are leading causes of maternal mortality worldwide. We assessed the relation between IPV and risk of preeclampsia among Peruvian women.
We conducted a case-control study at two large hospitals in Lima, Peru. Preeclampsia cases were 339 women with pregnancy-induced hypertension and proteinuria (i.e., preeclampsia). Controls were 337 normotensive women. Information concerning women's exposure to physical and emotional violence during pregnancy was collected during in-person interviews conducted after delivery and while patients were in hospital. Odds ratios (OR) and 95% confidence intervals (CI) were estimated from logistic regression models.
The prevalence of IPV was 43.1% among cases and 24.3% among controls. Compared with those reporting never exposure to IPV during pregnancy, women reporting any exposure had a 2.4-fold increased risk of preeclampsia (OR=2.4; 95% CI: 1.7-3.3). The association was strengthened slightly after adjusting for maternal age, parity and pre-pregnancy adiposity (OR=2.7; 95% CI: 1.9-3.9). Emotional abuse in the absence of physical violence was associated with a 3.2-fold (95% CI: 2.1-4.9) increased risk of preeclampsia. Emotional and physical abuse during pregnancy was associated with a 1.9-fold increased risk of preeclampsia (95% CI: 1.1-3.5).
IPV among pregnant women is common and is associated with an increased risk of preeclampsia. These data support recent calls for coordinated global health efforts to prevent violence against women.
越来越多的证据支持亲密伴侣暴力(IPV)是孕产妇死亡的重要原因这一观点。一些(但并非全部)先前的研究表明,IPV与孕产妇疾病风险增加有关,如妊娠期高血压疾病,这些疾病是全球孕产妇死亡的主要原因。我们评估了秘鲁女性中IPV与子痫前期风险之间的关系。
我们在秘鲁利马的两家大型医院进行了一项病例对照研究。子痫前期病例为339名患有妊娠高血压和蛋白尿(即子痫前期)的女性。对照组为337名血压正常的女性。在分娩后且患者住院期间进行的面对面访谈中,收集了有关女性孕期遭受身体和情感暴力的信息。通过逻辑回归模型估计比值比(OR)和95%置信区间(CI)。
病例组中IPV的患病率为43.1%,对照组为24.3%。与报告孕期从未遭受IPV的女性相比,报告有任何暴露的女性患子痫前期的风险增加了2.4倍(OR = 2.4;95% CI:1.7 - 3.3)。在调整了产妇年龄、产次和孕前肥胖后,这种关联略有增强(OR = 2.7;95% CI:1.9 - 3.9)。在没有身体暴力的情况下遭受情感虐待与子痫前期风险增加3.2倍(95% CI:2.1 - 4.9)有关。孕期遭受情感和身体虐待与子痫前期风险增加1.9倍(95% CI:1.1 - 3.5)有关。
孕妇中的IPV很常见,且与子痫前期风险增加有关。这些数据支持了近期全球卫生界呼吁协调一致努力预防针对妇女的暴力行为的主张。