Department of Epidemiology and Biostatistics, University of South Florida, 13201 Bruce B Downs, MDC56, Tampa, FL, 33612, USA,
Matern Child Health J. 2013 Dec;17(10):1817-24. doi: 10.1007/s10995-012-1201-x.
To measure the effect of a short interpregnancy interval (IPI), along with other indicators routinely asked during pregnancy on later report of child maltreatment. We hypothesized that an IPI of <18 months was associated with increased risk of child maltreatment. This study was a secondary analysis of a linked population-based dataset from 2005 to 2007 in Florida. Data were derived from three sources: Birth Certificates, Healthy Start Prenatal Risk Screens, and the HomeSafeNet Database. Primary predictor variables were IPI, and mothers' evaluations of the timing of the pregnancy and perceptions of harm. Logistic regression analyses were used to estimate the odds of child maltreatment, adjusting for demographic and other known risk factors for maltreatment. The final study sample consisted of 85,258 multipara women-infant dyads with credible IPIs and with completed Healthy Start Prenatal Risk Screens. Seventeen percent of children had a report of child maltreatment in the first 5 years of life. An IPI of less than 18 months was associated with 18 % higher odds of maltreatment compared to an IPI of greater than 18 months (95 % CI 1.13, 1.23). Mothers' perception of harm and desire to be pregnant at a later time were also significantly associated with higher odds of maltreatment report (AOR = 2.43 95 % CI = 2.17, 2.71 and AOR = 1.18 95 % CI 1.13, 1.24, respectively). Ascertaining short IPI and asking pregnant and peripartum women about their perception of harm and desire for a longer birth spacing can alert obstetricians, family practitioners and pediatricians to potential child maltreatment.
为了衡量短间隔妊娠（IPI）以及妊娠期间常规询问的其他指标对后期儿童虐待报告的影响，我们假设 IPI<18 个月与儿童虐待风险增加相关。本研究是对 2005 年至 2007 年佛罗里达州基于人群的关联数据集的二次分析。数据来自三个来源：出生证明、健康启动产前风险筛查和 HomeSafeNet 数据库。主要预测变量是 IPI 以及母亲对妊娠时间的评估和对伤害的感知。使用逻辑回归分析来估计儿童虐待的几率，同时调整了虐待的人口统计学和其他已知风险因素。最终研究样本包括 85258 名多胎妇女-婴儿对，这些妇女具有可信的 IPI 且完成了健康启动产前风险筛查。在生命的前 5 年，17%的儿童有报告称遭受了儿童虐待。与 IPI>18 个月相比，IPI<18 个月与虐待的几率增加 18%相关（95%CI 1.13，1.23）。母亲对伤害的感知和希望稍后怀孕的愿望也与更高的虐待报告几率显著相关（AOR=2.43，95%CI=2.17，2.71 和 AOR=1.18，95%CI 1.13，1.24）。确定短 IPI 并询问怀孕和围产期妇女对伤害的感知和对更长生育间隔的渴望，可以提醒产科医生、家庭医生和儿科医生注意潜在的儿童虐待。
