Ackerson Leland K, Subramanian S V
Department of Community Health and Sustainability, University of Massachusetts Lowell, Lowell, Massachusetts 01854, USA.
Pediatrics. 2009 Nov;124(5):e878-89. doi: 10.1542/peds.2009-0524. Epub 2009 Oct 12.
The goal was to test the association between maternal intimate partner violence (IPV) victimization and child death.
Information was collected regarding 39096 children <60 months of age in the nationally representative 2005-2006 National Family Health Survey of India. The exposures were maternal reports of physical, sexual, psychological, and any IPV. Outcomes included infant (0 to <12 months), older child (12 to <60 months), and any child (0 to <60 months) deaths.
Maternal experience of physical IPV was associated with increased mortality rates among all children (risk ratio [RR]: 1.21 [95% confidence interval [CI]: 1.13-1.30]), infants (RR: 1.24 [95% CI: 1.01-1.53]), and older children (RR: 1.25 [95% CI: 1.00-1.56]). Sexual and psychological IPV were less strongly associated with child death. The associations between maternal IPV and death did not differ according to the child's gender.
The robust association between exposure to household IPV and infant and child death could be attributable to the mother's inability to care for her child, psychological stress associated with witnessing violence, and the use of maternal violence victimization as a proxy for child violence victimization.
本研究旨在检验母亲遭受亲密伴侣暴力(IPV)与儿童死亡之间的关联。
在具有全国代表性的2005 - 2006年印度全国家庭健康调查中,收集了39096名60个月以下儿童的相关信息。暴露因素为母亲报告的身体暴力、性暴力、心理暴力以及任何形式的亲密伴侣暴力。结局包括婴儿(0至<12个月)、大龄儿童(12至<60个月)以及任何儿童(0至<60个月)的死亡情况。
母亲遭受身体亲密伴侣暴力与所有儿童(风险比[RR]:1.21[95%置信区间[CI]:1.13 - 1.30])、婴儿(RR:1.24[95%CI:1.01 - 1.53])和大龄儿童(RR:1.25[95%CI:1.00 - 1.56])死亡率的增加相关。性暴力和心理暴力与儿童死亡的关联较弱。母亲遭受亲密伴侣暴力与儿童死亡之间的关联在儿童性别上并无差异。
接触家庭亲密伴侣暴力与婴儿及儿童死亡之间的紧密关联可能归因于母亲无力照顾孩子、目睹暴力带来的心理压力,以及将母亲遭受暴力作为儿童遭受暴力的替代指标。