Department of Population, Family, and Reproductive Health, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
Int J Epidemiol. 2010 Jun;39(3):825-33. doi: 10.1093/ije/dyq066. Epub 2010 May 5.
To investigate the relationship between domestic violence and perinatal, neonatal and infant mortality in rural India using prospective data.
The study is based upon a prospective follow-up study of a cohort selected from the 1998-99 National Family and Health Survey-2 (NSFS-2), which was carried out in 2002-03 in four Indian states. Data for a total of 3909 birth outcomes that took place during this 4-year period were analysed using bivariate analysis and hazards regression analysis to control for truncated observations and possible other confounding factors. Findings After controlling for other potentially confounding factors, births to mothers who experienced two or more episodes of recent domestic violence experienced higher perinatal [hazards ratio (HR) = 1.85, 95% confidence interval (CI) = 1.12, 2.79] and neonatal (HR = 1.62, 95% CI = 1.11, 2.53) mortality, relative to births to women whose mothers reported no violence. Overall, these births to women who experienced violence had 68% higher risk of infant mortality compared with the 'no violence' group. Births to women who experienced a single episode of violence were not at higher risk of mortality.
Our study provides additional and more conclusive evidence on the importance of domestic violence for early childhood mortality in low-resource settings such as rural India. The results argue for a greater focus upon such violence within current child survival programmes.
利用前瞻性数据研究印度农村地区家庭暴力与围产儿、新生儿和婴儿死亡率之间的关系。
本研究基于对 1998-99 年全国家庭健康调查-2(NFHS-2)中选择的队列进行的前瞻性随访研究,该研究于 2002-03 年在印度四个邦进行。使用双变量分析和风险回归分析对这 4 年期间发生的总共 3909 例分娩结果进行分析,以控制截断观察和可能存在的其他混杂因素。
在控制其他潜在混杂因素后,经历过两次或两次以上近期家庭暴力事件的母亲所生的婴儿,其围产期(风险比[HR] = 1.85,95%置信区间[CI] = 1.12,2.79)和新生儿(HR = 1.62,95%CI = 1.11,2.53)死亡率更高,与未报告暴力的母亲所生的婴儿相比。总体而言,与“无暴力”组相比,经历过暴力的母亲所生的婴儿死于婴儿期的风险高 68%。经历过单次暴力事件的母亲所生的婴儿没有更高的死亡风险。
我们的研究为在资源匮乏的环境中,如印度农村地区,家庭暴力对儿童早期死亡的重要性提供了更多的、更确凿的证据。结果表明,在当前的儿童生存方案中,需要更加关注这种暴力行为。