Miura Ayano, Fujiwara Takeo
Department of Social Medicine, National Research Institute for Child Health and Development, Tokyo, Japan.
Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan.
Front Public Health. 2017 Apr 24;5:81. doi: 10.3389/fpubh.2017.00081. eCollection 2017.
The impact of intimate partner violence (IPV) on postpartum depression (PPD) has been reported in various countries by many studies. However, the association between IPV and PPD in Japan has been scarce. In addition to the limited number of research on the relationship between IPV and PPD, the number of women seeking help from IPV support centers has been steadily increasing in Japan. Hence, it is of interest to explore the relationship between IPV during pregnancy and PPD in Japan.
Four-page questionnaires assessing sociodemographic characteristics, women's personal situation during pregnancy, and PPD were mailed to participants prior to the checkup and collected at the checkup sites or mailed back to the health center. Of 9,707 eligible mothers, 6,590 responded to a questionnaire at a 3- or 4-month infant health checkup (response rate: 68%). Verbal and physical IPV from partners was assessed with two questions in the questionnaire. Logistic regression analysis was conducted. PPD was evaluated using the Edinburgh Postnatal Depression Scale (EPDS) with a cutoff score of 8/9.
Partners' verbal and physical abuse during pregnancy was significantly associated with PPD after adjusting for possible confounders. Specifically, odds ratios (ORs) of PPD for women who had been verbally abused by their partners during pregnancy at a frequency of "often" were 4.85 (95% CI, 2.23-10.55). ORs of PPD among women who had been physically abused by their partners during pregnancy at a frequency of "sometimes or often" were 7.05 (95% CI, 2.76-17.98). A positive dose-response relationship between both types of IPV and PPD was statistically significant (both < 0.001). In addition, about 80% of physically abused women reported being verbally abused as well, indicating that these forms of IPV were highly comorbid.
Both verbal and physical IPV during pregnancy is associated with PPD in Japan. This is the first study investigating the impact of IPV on PPD using a large number of subjects in the country. Further study using the same participants of the current study would allow us to explore the causality between IPV during pregnancy and PPD.
许多研究已在不同国家报道了亲密伴侣暴力（IPV）对产后抑郁症（PPD）的影响。然而，在日本，IPV与PPD之间的关联却很罕见。除了关于IPV与PPD关系的研究数量有限外，在日本，向IPV支持中心寻求帮助的女性人数一直在稳步增加。因此，探究日本孕期IPV与PPD之间的关系很有意义。
在体检前，向参与者邮寄了一份四页的问卷，评估社会人口学特征、女性孕期个人情况以及PPD情况，并在体检地点收集问卷或邮寄回健康中心。在9707名符合条件的母亲中，有6590名在婴儿3或4个月健康检查时对问卷做出了回应（回复率：68%）。问卷中的两个问题用于评估伴侣的言语和身体暴力行为。进行了逻辑回归分析。使用爱丁堡产后抑郁量表（EPDS）评估PPD，临界值为8/9。
在对可能的混杂因素进行调整后，孕期伴侣的言语和身体虐待与PPD显著相关。具体而言，孕期经常遭受伴侣言语虐待的女性患PPD的比值比（OR）为4.85（95%置信区间，2.23 - 10.55）。孕期有时或经常遭受伴侣身体虐待的女性患PPD的OR为7.05（95%置信区间，2.76 - 17.98）。两种类型的IPV与PPD之间的正剂量反应关系具有统计学意义（均<0.001）。此外，约80%遭受身体虐待的女性也报告遭受言语虐待，这表明这些形式的IPV高度共病。
在日本，孕期的言语和身体IPV均与PPD相关。这是该国第一项使用大量受试者研究IPV对PPD影响的研究。使用本研究的相同参与者进行进一步研究将使我们能够探究孕期IPV与PPD之间的因果关系。
