基于人群样本的围产期女性亲密伴侣暴力与孕期体重增加情况
Intimate Partner Violence and Gestational Weight Gain in a Population-Based Sample of Perinatal Women.
作者信息
Alhusen Jeanne L, Geller Ruth, Dreisbach Caitlin, Constantoulakis Leeza, Siega-Riz Anna Maria
出版信息
J Obstet Gynecol Neonatal Nurs. 2017 May-Jun;46(3):390-402. doi: 10.1016/j.jogn.2016.12.003. Epub 2017 Mar 11.
OBJECTIVE
To examine the effects of intimate partner violence (IPV) at varied time points in the perinatal period on inadequate and excessive gestational weight gain.
DESIGN
Retrospective cohort using population-based secondary data.
SETTING
Pregnancy Risk Assessment Monitoring System and birth certificate data from New York City and 35 states.
PARTICIPANTS
Data were obtained for 251,342 U.S. mothers who gave birth from 2004 through 2011 and completed the Pregnancy Risk Assessment Monitoring System survey 2 to 9 months after birth.
METHODS
The exposure was perinatal IPV, defined as experiencing physical abuse by a current or ex-partner in the year before or during pregnancy. Adequacy of gestational weight gain (GWG) was categorized using 2009 Institute of Medicine guidelines. Weighted descriptive statistics and multivariate logistic regression models were used.
RESULTS
Approximately 6% of participants reported perinatal IPV, 2.7% reported IPV in the year before pregnancy, 1.1% reported IPV during pregnancy only, and the remaining 2.5% reported IPV before and during pregnancy. Inadequate GWG was more prevalent among participants who experienced IPV during pregnancy and those who experienced IPV before and during pregnancy (23.3% and 23.5%, respectively) than in participants who reported no IPV (20.2%; p < .001). Participants who experienced IPV before pregnancy only were significantly more likely to have excessive GWG (p < .001). Results were attenuated in the multivariate modeling; only participants who experienced IPV before pregnancy had weakly significant odds of excessive GWG (adjusted odds ratio = 1.14, 95% CI [1.02, 1.26]).
CONCLUSION
The association between perinatal IPV and inadequate GWG was explained by confounding variables; however, women who reported perinatal IPV had greater rates of GWG outside the optimal range. Future studies are needed to determine how relevant confounding variables may affect a woman's GWG.
目的
探讨围产期不同时间点的亲密伴侣暴力（IPV）对孕期体重增加不足和过多的影响。
设计
基于人群的二次数据进行回顾性队列研究。
地点
纽约市及35个州的妊娠风险评估监测系统和出生证明数据。
参与者
获取了2004年至2011年间分娩且在产后2至9个月完成妊娠风险评估监测系统调查的251342名美国母亲的数据。
方法
暴露因素为围产期IPV，定义为在怀孕前一年或怀孕期间遭受现任或前任伴侣的身体虐待。根据2009年医学研究所的指南对孕期体重增加（GWG）是否充足进行分类。使用加权描述性统计和多变量逻辑回归模型。
结果
约6%的参与者报告了围产期IPV，2.7%报告在怀孕前一年遭受IPV，1.1%仅报告在怀孕期间遭受IPV，其余2.5%报告在怀孕前和怀孕期间均遭受IPV。孕期遭受IPV的参与者以及怀孕前和怀孕期间均遭受IPV的参与者中，GWG不足的情况比未报告IPV的参与者更为普遍（分别为23.3%和23.5%，而未报告IPV的参与者为20.2%；p<0.001）。仅在怀孕前遭受IPV的参与者体重增加过多的可能性显著更高（p<0.001）。在多变量建模中结果有所减弱；只有怀孕前遭受IPV的参与者体重增加过多的几率有微弱的显著性（调整后的优势比=1.14，95%置信区间[1.02，1.26]）。
结论
围产期IPV与GWG不足之间的关联可由混杂变量解释；然而，报告围产期IPV的女性GWG超出最佳范围的比例更高。需要进一步研究以确定相关混杂变量如何影响女性的GWG。
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