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妊娠前后伴侣身体暴力与妊娠体重不足的关联性。

Association of physical violence by an intimate partner around the time of pregnancy with inadequate gestational weight gain.

机构信息

Graduate Program in Public Health, Eastern Virginia Medical School, Norfolk, VA 23507, USA.

出版信息

Soc Sci Med. 2011 Mar;72(6):867-73. doi: 10.1016/j.socscimed.2011.01.006. Epub 2011 Jan 31.

Abstract

Intimate partner violence has been previously examined in relation to a variety of pregnancy, labor and delivery outcomes. We evaluated whether women who experienced physical violence by their intimate partners around the time of pregnancy were less likely to achieve weight gain according to the US Institute of Medicine (IOM) guidelines. A cross-sectional study was conducted using the 2000-2006 Oklahoma Pregnancy Risk Assessment Monitoring Survey (PRAMS) data for post-partum women, 20 years and older. Physical violence perpetrated by an intimate partner before and/or during pregnancy was prevalent in nearly 6.5% of women. Weight gain was adequate in 38.8%, deficient in 28.4% and excessive in 32.8% of these women, respectively. After adjusting for maternal age, marital status, education, pregnancy intention, stressful life events, third-trimester use of tobacco and alcohol and gestational age at delivery, physical violence by an intimate partner around the time of pregnancy was positively but non-significantly associated with excessive (but not deficient) gestational weight gain. After stratifying by age group, positive and significant associations between physical violence by an intimate partner around the time of pregnancy and inadequate gestational weight gain were observed only among women 35 years and older. With the exception of mothers ≥ 35 years of age, deficient and excessive gestational weight gains were not significantly related to experiences with physical violence by an intimate partner prior to delivery. Prospective cohort studies are needed to establish whether other forms of violence, including emotional and sexual abuse, can affect gestational weight gain and whether gestational weight gain can mediate the effect of physical, sexual and emotional abuse on pregnancy, labor and delivery outcomes.

摘要

亲密伴侣暴力已经在多种妊娠、分娩和分娩结局方面进行了研究。我们评估了在妊娠期间遭受亲密伴侣身体暴力的女性是否不太可能根据美国医学研究所(IOM)的指南增加体重。使用 2000-2006 年俄克拉荷马州产后风险评估监测调查(PRAMS)的数据,对 20 岁及以上的产后妇女进行了一项横断面研究。在妊娠前和/或妊娠期间,亲密伴侣实施的身体暴力在近 6.5%的女性中很普遍。这些女性的体重增加分别为 38.8%充足、28.4%不足和 32.8%过多。在调整了母亲年龄、婚姻状况、教育程度、妊娠意图、生活压力事件、孕晚期使用烟草和酒精以及分娩时的胎龄后,妊娠期间亲密伴侣的身体暴力与过多(而非不足)的妊娠期体重增加呈正相关,但无统计学意义。按年龄组分层后,只有 35 岁及以上的女性中,妊娠期间亲密伴侣的身体暴力与妊娠期体重不足增加呈正相关且具有统计学意义。除了年龄≥35 岁的母亲外,不足和过多的妊娠期体重增加与分娩前亲密伴侣的身体暴力经历没有显著关系。需要前瞻性队列研究来确定其他形式的暴力,包括情感和性虐待,是否会影响妊娠期体重增加,以及妊娠期体重增加是否可以调解身体、性和情感虐待对妊娠、分娩和分娩结局的影响。

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