Hoang Thanh Nguyen, Van Toan Ngo, Gammeltoft Tine, W Meyrowitsch Dan, Nguyen Thi Thuy Hanh, Rasch Vibeke
Institute of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam.
Department of Anthropology, University of Copenhagen, Copenhagen, Denmark.
PLoS One. 2016 Sep 15;11(9):e0162844. doi: 10.1371/journal.pone.0162844. eCollection 2016.
Violence against pregnant women is an increasing public health concern particularly in low- and middle-income countries. The purpose of this study was to measure the association between intimate partner violence (IPV) during pregnancy and the risk of adverse birth outcomes.
Prospective cohort study of 1276 pregnant women in Dong Anh district, Vietnam. Women with gestational age less than 24 weeks were enrolled and interviewed. Repeated interviews were performed at 30-34 weeks gestation to assess experience of IPV during pregnancy and again 48 hours post-delivery to assess the birth outcome including birth weight and gestational age at delivery.
There was a statistically significant association between exposure to physical violence during pregnancy and preterm birth (PTB) or low birth weight (LBW). After adjustment for age, education, occupation, body mass index (BMI), haemoglobin level, previous adverse pregnancy outcomes, the pregnant women who were exposed to physical violence during pregnancy were five times more likely to have PTB (AOR = 5.5; 95%CI: 2.1-14.1) and were nearly six times more likely to give birth to a child of LBW (AOR = 5.7; 95%CI: 2.2-14.9) as compared to those who were not exposed to physical violence.
Exposure to IPV during pregnancy increases the risk of PTB and LBW. Case-finding for violence in relation to antenatal care may help protect pregnant women and improve pregnancy outcomes.
针对孕妇的暴力行为日益引起公众对健康问题的关注，在低收入和中等收入国家尤为如此。本研究的目的是衡量孕期亲密伴侣暴力（IPV）与不良分娩结局风险之间的关联。
对越南东英县的1276名孕妇进行前瞻性队列研究。纳入孕周小于24周的孕妇并进行访谈。在妊娠30 - 34周时进行重复访谈，以评估孕期IPV经历，并在分娩后48小时再次访谈，以评估分娩结局，包括出生体重和分娩时的孕周。
孕期遭受身体暴力与早产（PTB）或低出生体重（LBW）之间存在统计学上的显著关联。在对年龄、教育程度、职业、体重指数（BMI）、血红蛋白水平、既往不良妊娠结局进行调整后，孕期遭受身体暴力的孕妇发生PTB的可能性是未遭受身体暴力孕妇的5倍（调整后比值比[AOR]=5.5；95%置信区间[CI]：2.1 - 14.1），生出低出生体重儿的可能性几乎是未遭受身体暴力孕妇的6倍（AOR = 5.7；95%CI：2.2 - 14.9）。
孕期遭受IPV会增加PTB和LBW的风险。在产前检查中发现暴力相关情况可能有助于保护孕妇并改善妊娠结局。
