Rao Deepa, Kumar Shuba, Mohanraj Rani, Frey Sarah, Manhart Lisa E, L Kaysen Debra
Departments of Global Health, Psychiatry and Behavioral Sciences, University of Washington, Box 359931, 325 9th Ave, Seattle, WA, 98104, USA.
Samarth, Chennai, India.
Soc Psychiatry Psychiatr Epidemiol. 2016 Feb;51(2):225-32. doi: 10.1007/s00127-015-1167-2. Epub 2016 Jan 8.
India has the highest absolute number of maternal deaths, preterm birth cases, and under-5 mortality in the world, as well as high domestic violence (DV) rates. We sought to examine the impact of DV and its psychosocial correlates on pregnancy and birth outcomes.
Women seeking antenatal care in Tamil Nadu, South India (N = 150) were assessed during pregnancy, and birth outcomes were abstracted from medical records after the babies were born.
We found that psychological abuse (OR 3.9; 95% CI 1.19-12.82) and mild or greater depressive symptoms (OR 3.3; 95% CI 0.99-11.17) were significantly associated with increased risk of preterm birth. Physical abuse was also associated with increased risk of preterm birth, but this was not statistically significant (OR 1.9; 95% CI 0.59-6.19). In each of the above adjusted models, low maternal education was associated with increased risk of preterm birth, in the analysis with depressive symptoms OR 0.18, CI 0.04-0.86 and in the analyses with psychological abuse OR 0.19, CI 0.04-0.91.
These findings suggest that future research should focus on understanding the psychosocial antecedents to preterm birth, to better target interventions and improve maternal child health in limited resource settings.
印度是世界上孕产妇死亡、早产病例和5岁以下儿童死亡率绝对数量最高的国家，同时家庭暴力（DV）发生率也很高。我们试图研究家庭暴力及其心理社会相关因素对妊娠和分娩结局的影响。
对印度南部泰米尔纳德邦寻求产前护理的妇女（N = 150）在孕期进行评估，并在婴儿出生后从医疗记录中提取分娩结局信息。
我们发现，心理虐待（比值比3.9；95%置信区间1.19 - 12.82）和轻度或更严重的抑郁症状（比值比3.3；95%置信区间0.99 - 11.17）与早产风险增加显著相关。身体虐待也与早产风险增加有关，但无统计学意义（比值比1.9；95%置信区间0.59 - 6.19）。在上述每个校正模型中，母亲教育程度低与早产风险增加相关，在抑郁症状分析中比值比为0.18，置信区间为0.04 - 0.86，在心理虐待分析中比值比为0.19，置信区间为0.04 - 0.91。
这些发现表明，未来的研究应侧重于了解早产的心理社会先兆，以便在资源有限的环境中更好地确定干预目标并改善母婴健康。
