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法国孕期的身体暴力:发生率及对母婴健康的影响。

Physical Violence During Pregnancy in France: Frequency and Impact on the Health of Expectant Mothers and New-Borns.

机构信息

INSERM UMR 1153- Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, Hôpital Tenon - Batiment Recherche 4 rue de la Chine, Paris, 75020, France.

Department of Public Health, Federal University of Maranhao, Sao Luis, Brazil.

出版信息

Matern Child Health J. 2019 Aug;23(8):1108-1116. doi: 10.1007/s10995-019-02747-y.

Abstract

Objectives Even during pregnancy women may suffer from violence. We estimated the prevalence of physical abuse during pregnancy, we analyzed the main risk factors and described the relationship between physical violence, psychological wellbeing and pregnancy outcome. Methods We used a national representative sample of births, in all public and private maternity units, in 2016 in France. Women were interviewed after delivery, on their living conditions and occurrence of physical violence at least once during pregnancy. The study of risk factors and pregnancy outcome was done with multivariable logistic regressions. Results Of 12,330 women included in the analysis 1.8% (95% CI 1.6-2.0) had been exposed to physical violence during pregnancy. Risk of violence was associated with the couple situation [women without a partner or in couple not cohabiting (OR 2.89, 95% CI 1.96-4.26)], household income (less than 3000 euros monthly), and state medical assistance coverage. Physical violence was more prevalent in case of a history of induced abortion or cannabis use during pregnancy. Psychological distress was more frequent with than without physical violence (e.g., 62% vs. 24% had a sadness period during pregnancy, p < 0.001). The risk of spontaneous preterm birth and transfer of the newborn to a neonatal intensive care unit were significantly higher among women experiencing physical violence during pregnancy compared to other women. Conclusions for Practice Main factors associated with increased risk of violence during pregnancy were socio-economics. The identification by caregivers of women exposed to violence during pregnancy needs to be improved to develop preventive and care strategies.

摘要

目的

即使在怀孕期间,女性也可能遭受暴力。我们评估了怀孕期间身体虐待的流行率,分析了主要的危险因素,并描述了身体暴力、心理健康和妊娠结局之间的关系。

方法

我们使用了 2016 年法国所有公立和私立产科单位的全国代表性出生样本。女性在分娩后接受采访,询问她们的生活状况以及怀孕期间至少一次遭受身体暴力的情况。使用多变量逻辑回归分析了危险因素和妊娠结局。

结果

在纳入分析的 12330 名女性中,有 1.8%(95%CI 1.6-2.0)在怀孕期间遭受过身体暴力。暴力风险与伴侣状况[无伴侣或未同居的女性(OR 2.89,95%CI 1.96-4.26)]、家庭收入(每月少于 3000 欧元)和国家医疗补助覆盖范围有关。有过人工流产或怀孕期间使用大麻史的女性发生暴力的风险更高。与没有身体暴力的女性相比,有身体暴力的女性心理困扰更为常见(例如,怀孕期间有悲伤期的女性比例为 62% vs. 24%,p<0.001)。与其他女性相比,怀孕期间遭受身体暴力的女性发生自发性早产和新生儿转入新生儿重症监护病房的风险显著更高。

结论

与怀孕期间暴力风险增加相关的主要因素是社会经济因素。需要提高护理人员对怀孕期间遭受暴力女性的识别能力,以制定预防和护理策略。

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