College of Health Sciences, University of Dodoma, P.O Box 395, Dodoma, Tanzania.
Gender Violence & Health Centre, Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK.
J Affect Disord. 2018 Mar 15;229:159-163. doi: 10.1016/j.jad.2017.12.036. Epub 2017 Dec 27.
Adverse childhood experiences (ACEs) and intimate partner violence (IPV) are recognized global health problems. Both ACEs and IPV have been linked to adverse physical and mental health problems for both mothers and infants. The aim of this study was to determine the prevalence of physical and/or sexual ACEs and IPV and their association to symptoms of postpartum depression among postpartum women in sub-Saharan Africa.
A cross-sectional survey was conducted in three health centers in the three districts of Dar es Salaam, comprising Ilala, Kinondoni and Temeke. A total of 500 women were interviewed by two trained midwife nurses during their routine postnatal care. The women were asked about their experiences of adverse childhood experiences, intimate partner violence and symptoms of postpartum depression.
Of the 500 women who were interviewed, 39.4% (n = 197) reported to have experienced physical and/or sexual ACE and 18.8% (n = 94) experienced physical and/or sexual IPV during their index pregnancy. Physical ACE (AOR 2.6, 95% CI: 1.50-4.57), sexual ACE (AOR 2.7, 95% CI: 1.35-5.41), physical IPV (AOR 5.8, 95% CI: 2.98-11.43) and Sexual IPV (AOR 5.5, 95%CI: 2.51, 12.09) were significantly associated with symptoms of postpartum depression.
Four out of ten women reported to have experienced ACEs and two out of ten women reported IPV in the index pregnancy which was significantly associated with symptoms of postpartum depression. These results are alarming and call upon the attention of health workers and the community at large in prevention, screening and early intervention of ACEs, IPV and symptoms of postpartum depression.
不良儿童经历（ACEs）和亲密伴侣暴力（IPV）是公认的全球健康问题。ACEs 和 IPV 都与母亲和婴儿的身心健康问题有关。本研究旨在确定撒哈拉以南非洲地区产后妇女身体和/或性 ACEs 和 IPV 的流行情况及其与产后抑郁症症状的关系。
在达累斯萨拉姆的三个区（伊拉拉、金多尼和特梅克）的三个卫生中心进行了横断面调查。共有 500 名妇女在例行产后护理期间由两名经过培训的助产士护士进行访谈。这些妇女被问及她们在童年时期的不良经历、亲密伴侣暴力和产后抑郁症症状。
在接受访谈的 500 名妇女中，39.4%（n=197）报告在指数妊娠期间经历过身体和/或性 ACE，18.8%（n=94）经历过身体和/或性 IPV。身体 ACE（AOR 2.6，95%CI：1.50-4.57）、性 ACE（AOR 2.7，95%CI：1.35-5.41）、身体 IPV（AOR 5.8，95%CI：2.98-11.43）和性 IPV（AOR 5.5，95%CI：2.51-12.09）与产后抑郁症症状显著相关。
十分之四的妇女报告在指数妊娠期间经历过 ACEs，十分之二的妇女报告在指数妊娠期间经历过 IPV，这与产后抑郁症症状显著相关。这些结果令人震惊，呼吁卫生工作者和整个社区关注 ACEs、IPV 和产后抑郁症症状的预防、筛查和早期干预。
