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孕期及产后一年半内家庭暴力的患病率和发病率上升情况以及风险因素:瑞典南部的一项纵向队列研究

Increasing prevalence and incidence of domestic violence during the pregnancy and one and a half year postpartum, as well as risk factors: -a longitudinal cohort study in Southern Sweden.

作者信息

Finnbogadóttir Hafrún, Dykes Anna-Karin

机构信息

Department of Care Science, Faculty of Health and Society, Malmoe University, Malmoe, Sweden.

Department of Health Sciences, Medical Faculty, Lund University, Lund, Sweden.

出版信息

BMC Pregnancy Childbirth. 2016 Oct 26;16(1):327. doi: 10.1186/s12884-016-1122-6.

Abstract

BACKGROUND

Domestic violence is a global health problem as well as a violation against human rights. The aim of this study was to explore prevalence and incidence of domestic violence during pregnancy and 1 to 1.5 years postpartum as well as to explore the history of violence among new mothers in the southwestern region of Sweden. In addition, the aim was to explore the association between domestic violence postpartum and possible risk factors.

METHODS

This is a longitudinal cohort-study including pregnant women ≥ 18 years of age. Total 1939 pregnant women were recruited to the study and requested to answer three questionnaires (QI-III) during pregnancy and postpartum. Statistical analysis were descriptive statistics, logistic regression and multiple regression with Odds ratios (OR) and 95 % confidence intervals (95 % CI).

RESULTS

The response rate for those who received the Q-III (n = 755) at a Child Welfare Center was almost 97 % (n = 731). When all three questionnaires were answered the prevalence of domestic violence during pregnancy irrespective of type or severity was reported by 2.5 % (n = 40/1573). At 1 to 1.5 years postpartum the prevalence of domestic violence had increased to 3.3 % (n = 23/697). The incidence was 14 per 1000 women during pregnancy and 17.2 per 1000 women postpartum. The strongest risk factor for domestic violence reported at1-1.5 years postpartum was a history of violence whereby all of the women (n = 23) who had revealed their exposure to domestic violence postpartum also reported a history of violence (p < 0.001). Being single/living apart gave a 12.9 times higher risk for domestic violence postpartum (AOR 12.9; 95 % CI: 4.5-37.1). Having several symptoms of depression and a low score on the SOC-scale gave a 3.5 and 3.0 times higher risk respectively (AOR 3.5; 95 % CI: 1.2-10.4) and (AOR 3.0; 95 % CI 1.1-8.3).

CONCLUSION

Domestic violence increases as the pregnancy develops and postpartum. A history of violence and being single/living apart may be strong indicators for domestic violence during pregnancy as well as postpartum. Also, having symptoms of depression are associated with domestic violence both during pregnancy and postpartum. Collaboration between health care providers at Antenatal and Welfare centres is essential.

摘要

背景

家庭暴力是一个全球性的健康问题,也是一种侵犯人权的行为。本研究的目的是探讨孕期及产后1至1.5年家庭暴力的患病率和发病率,并探究瑞典西南部地区初为人母者的暴力史。此外,研究目的还包括探讨产后家庭暴力与可能的风险因素之间的关联。

方法

这是一项纵向队列研究,纳入年龄≥18岁的孕妇。总共招募了1939名孕妇参与研究,并要求她们在孕期和产后回答三份问卷(问卷一至问卷三)。统计分析采用描述性统计、逻辑回归和多元回归,计算比值比(OR)和95%置信区间(95%CI)。

结果

在儿童福利中心收到问卷三(n = 755)的人群中,回复率近97%(n = 731)。当三份问卷全部得到回答时,报告的孕期家庭暴力患病率(不论类型或严重程度)为2.5%(n = 40/1573)。产后1至1.5年时,家庭暴力患病率增至3.3%(n = 23/697)。孕期发病率为每1000名女性中有14例,产后为每1000名女性中有17.2例。产后1至1.5年报告的家庭暴力最强风险因素是暴力史,即所有产后透露遭受家庭暴力的女性(n = 23)也都报告有暴力史(p < 0.001)。单身/分居使产后遭受家庭暴力的风险高出12.9倍(调整后比值比12.9;95%CI:4.5 - 37.1)。有多种抑郁症状且社会支持量表得分低分别使风险高出3.5倍和3.0倍(调整后比值比3.5;95%CI:1.2 - 10.4)和(调整后比值比3.0;95%CI 1.1 - 8.3)。

结论

随着孕期进展和产后,家庭暴力有所增加。暴力史以及单身/分居可能是孕期及产后家庭暴力的有力指标。此外,抑郁症状在孕期和产后均与家庭暴力有关。产前保健提供者与福利中心之间的合作至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36a3/5081903/81771c93436b/12884_2016_1122_Fig1_HTML.jpg

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