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儿童期逆境与随后一次或多次流产风险。

Childhood adversities and subsequent risk of one or multiple abortions.

机构信息

Department of Psychiatry, University of California, San Francisco, 3333 California St., Ste. 465, Box 0848, San Francisco, CA 94143-0848, USA.

出版信息

Soc Sci Med. 2013 Mar;81:53-9. doi: 10.1016/j.socscimed.2012.11.011. Epub 2012 Nov 17.

Abstract

Although many studies have found an association between childhood adversities and mental health disorders, few have examined whether childhood adversities are linked to having abortions. This research investigates the association between a range of childhood adversities and risk of abortion in part to identify which adversities should be considered when examining the association between abortion and subsequent mental health. Using the U.S. National Comorbidity Survey-Replication (NCS-R), we tested the association between 10 childhood adversities and risk of 0, 1, or multiple abortions among 1511 women ages 18-41. We employed multinomial logistic regression to examine the independent association between each childhood adversity and number of subsequent abortions, controlling for sociodemographic factors, total number of pregnancies, and each adversity. Women who had experienced two or more personal safety threats, one parental mental illness, or two or more parental mental illnesses while growing up were more likely subsequently to have multiple versus no abortions [Relative Risk Ratio (RRR) = 9.87, 95% CI: 2.45-39.72; OR = 2.81, 95% CI: 1.27-6.21; RRR = 5.28, 95% CI: 1.60-17.38, respectively], and multiple versus one abortion [RRR = 13.33, 95% CI: 2.48-71.68; RRR = 2.17, 95% CI: 1.03-4.56; RRR = 3.67, 95% CI: 1.15-11.76, respectively]. Women who had experienced childhood physical abuse were more likely to have one compared to no abortions [RRR = 2.00; 1.19-3.34]. These results suggest that some childhood adversities may partially explain the association between abortion and mental health. Accordingly, they should be considered in future research examining the link between abortion and mental health.

摘要

尽管许多研究发现儿童期逆境与心理健康障碍之间存在关联,但很少有研究探讨儿童期逆境是否与堕胎有关。本研究调查了一系列儿童期逆境与堕胎风险之间的关联,部分目的是确定在研究堕胎与随后的心理健康之间的关联时,哪些逆境应被考虑。我们使用美国国家共病调查-复制(NCS-R),测试了 1511 名年龄在 18-41 岁的女性中 10 种儿童期逆境与 0、1 次或多次堕胎风险之间的关联。我们采用多项逻辑回归检验了每种儿童期逆境与随后堕胎次数之间的独立关联,控制了社会人口因素、总妊娠次数以及每种逆境。在成长过程中经历过两次或以上人身安全威胁、父母一方患有精神疾病或两次或以上父母双方患有精神疾病的女性,与没有堕胎的女性相比,更有可能随后多次堕胎(相对风险比(RRR)=9.87,95%置信区间:2.45-39.72;OR=2.81,95%置信区间:1.27-6.21;RRR=5.28,95%置信区间:1.60-17.38),与一次堕胎相比,多次堕胎(RRR=13.33,95%置信区间:2.48-71.68;RRR=2.17,95%置信区间:1.03-4.56;RRR=3.67,95%置信区间:1.15-11.76)。经历过儿童期身体虐待的女性与没有堕胎的女性相比,更有可能进行一次堕胎(RRR=2.00;1.19-3.34)。这些结果表明,一些儿童期逆境可能部分解释了堕胎与心理健康之间的关联。因此,在未来研究堕胎与心理健康之间的联系时,应考虑这些因素。

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