Robertson Blackmore Emma, Mittal Mona, Cai Xueya, Moynihan Jan A, Matthieu Monica M, O'Connor Thomas G
1 Department of Psychiatry, University of Rochester Medical Center , Rochester, New York.
2 Department of Psychiatry, University of Florida College of Medicine , Jacksonville, Jacksonville, Florida.
J Womens Health (Larchmt). 2016 Oct;25(10):1004-1013. doi: 10.1089/jwh.2015.5261. Epub 2016 Jan 8.
Intimate partner violence (IPV) is a public health concern, affecting one-third of US women. Prior research suggests an association between exposure to IPV and poor maternal perinatal health, but the underlying biological correlates are not well understood. This study examined the relationship between exposure to IPV and proinflammatory cytokine levels, a candidate mechanism accounting for poor psychiatric and obstetric outcomes, across the perinatal period.
Data were obtained from a prospective, longitudinal cohort study of 171 women receiving obstetrical care from a hospital-based practice serving a predominantly low-income minority population. Participants completed questionnaires on IPV exposure, psychiatric symptoms, and psychosocial and obstetric factors and provided blood samples at 18 and 32 weeks of gestation and 6 weeks and 6 months postpartum. Serum levels of interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α) were assayed via enzyme-linked immunosorbent assay.
Thirty-five (20.5%) women reported lifetime exposure to IPV and 7 (4.1%) reported being physically hurt in the preceding 12 months (4 while pregnant). Lifetime exposure to IPV was associated with increased likelihood of experiencing perinatal depression and smoking during pregnancy. Women with a history of IPV had significantly higher levels of TNF-α at 18 weeks (z = -2.29, p < 0.05), but significantly smaller changes in levels of IL-6 (β = -0.36, p = 0.04) across time.
Lifetime exposure to IPV was associated with a range of adverse mental health outcomes and may affect proinflammatory cytokine levels in pregnancy.
亲密伴侣暴力（IPV）是一个公共卫生问题，影响着三分之一的美国女性。先前的研究表明，遭受IPV与孕产妇围产期健康状况不佳之间存在关联，但潜在的生物学关联尚未得到充分理解。本研究调查了围产期遭受IPV与促炎细胞因子水平之间的关系，促炎细胞因子水平是导致不良精神和产科结局的一个可能机制。
数据来自一项前瞻性纵向队列研究，研究对象为171名接受产科护理的女性，她们来自一家主要服务低收入少数族裔人群的医院诊所。参与者完成了关于IPV暴露、精神症状、心理社会和产科因素的问卷调查，并在妊娠18周和32周以及产后6周和6个月提供了血液样本。通过酶联免疫吸附测定法检测血清白细胞介素-6（IL-6）和肿瘤坏死因子α（TNF-α）水平。
35名（20.5%）女性报告曾遭受过IPV，7名（4.1%）报告在过去12个月内受到身体伤害（4名在怀孕期间）。曾遭受IPV与围产期抑郁和孕期吸烟的可能性增加有关。有IPV病史的女性在18周时TNF-α水平显著升高（z = -2.29，p < 0.05），但IL-6水平随时间的变化显著较小（β = -0.36，p = 0.04）。
曾遭受IPV与一系列不良心理健康结局有关，可能会影响孕期促炎细胞因子水平。
