1 University of Virginia School of Nursing , Charlottesville, Virginia.
2 Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland.
J Womens Health (Larchmt). 2018 Apr;27(4):458-465. doi: 10.1089/jwh.2017.6322. Epub 2017 Aug 25.
Exposure to intimate partner violence (IPV) in the perinatal period is associated with obstetric complications, poor maternal mental health, neonatal complications, and increased risk of infant mortality and morbidity. Less is known about how IPV may influence small for gestational age (SGA) birth.
Data were obtained for 231,081 United States mothers who delivered neonates from 2004 to 2011 and completed the Pregnancy Risk Assessment Monitoring System survey 2-9 months after delivery. Weighted descriptive statistics and multivariate logistic regression models were used.
IPV in the year before or during pregnancy was related to SGA bivariately (odds ratio 1.39, 95% confidence interval [CI] 1.28, 1.51), and after adjustment for demographic and obstetric factors, this association attenuated after further adjustment for perinatal smoking patterns, (adjusted odds ratio [aOR] 1.06, 95% CI 0.97, 1.15). Compared with nonabused women, women experiencing perinatal IPV were more than twice as likely to smoke before pregnancy (aOR 2.34, 95% CI 2.19, 2.49), and nearly 1.5 times as likely to report sustained smoking into the last 3 months of pregnancy (aOR 1.45, 95% CI 1.32, 1.59). In turn, among prepregnancy smokers, sustained smoking was associated with delivery of a SGA neonate (aOR 1.87, 95% CI 1.72, 2.03), fully attenuating the association of perinatal IPV with SGA.
Women who experienced perinatal IPV were significantly more likely to smoke prepregnancy and sustain smoking into the last 3 months of pregnancy. Through behavioral and physiological pathways, smoking cessation may be uniquely challenging for women experiencing IPV, yet critical to address clinically to mitigate risk for SGA.
围产期内亲密伴侣暴力（IPV）的暴露与产科并发症、产妇心理健康不良、新生儿并发症以及婴儿死亡率和发病率增加有关。关于 IPV 如何影响胎儿生长受限（SGA）的出生，人们知之甚少。
数据来自 2004 年至 2011 年间在美国分娩的 231081 位母亲，这些母亲在分娩后 2-9 个月完成了妊娠风险评估监测系统调查。使用加权描述性统计和多变量逻辑回归模型。
妊娠前或妊娠期间的 IPV 与 SGA 呈双变量相关（优势比 1.39，95%置信区间 [CI] 1.28，1.51），并且在调整人口统计学和产科因素后，这种关联在进一步调整围产期吸烟模式后减弱（调整后的优势比[aOR]1.06，95%CI 0.97，1.15）。与未受虐待的女性相比，经历围产期 IPV 的女性在妊娠前吸烟的可能性高出两倍多（aOR 2.34，95%CI 2.19，2.49），并且在妊娠的最后 3 个月报告持续吸烟的可能性几乎高出 1.5 倍（aOR 1.45，95%CI 1.32，1.59）。反过来，在妊娠前吸烟者中，持续吸烟与 SGA 新生儿的分娩有关（aOR 1.87，95%CI 1.72，2.03），完全消除了围产期 IPV 与 SGA 之间的关联。
经历围产期 IPV 的女性更有可能在妊娠前吸烟，并在妊娠的最后 3 个月持续吸烟。通过行为和生理途径，戒烟对于经历 IPV 的女性可能特别具有挑战性，但对于临床缓解 SGA 风险至关重要。
