Department of Psychology, Kroc Institute for International Peace Studies, University of Notre Dame, Notre Dame, Indiana, USA.
J Trauma Stress. 2019 Aug;32(4):506-515. doi: 10.1002/jts.22414. Epub 2019 Jul 29.
Intimate partner violence (IPV) during and prior to pregnancy has been linked to higher rates of pregnancy complications and early labor and delivery. However, to our knowledge, no studies have examined prenatal mental health problems and relational resilience as parallel mechanisms by which past-year IPV exposure impacts pregnancy and labor. The current study aimed to (a) examine the contribution of IPV exposure to pregnancy complications and early labor and delivery, controlling for childhood adversity, and (b) assess prenatal mental health and relational resilience as mediators of the effect of IPV exposure on pregnancy complications and early labor and delivery. We hypothesized that IPV would predict higher levels of mental health problems and lower levels of relational resilience, each of which would contribute to women's risk of labor complications such that fewer mental health problems and higher levels of relational resilience would each be associated with fewer pregnancy complications and early labor and delivery. Participants were (n = 76) interviewed during pregnancy and 6 weeks postdelivery. No direct effect of IPV exposure on either pregnancy complications or labor complications was found. Parallel indirect effects of IPV on labor via prenatal mental health, indirect effect size = -.09; 95% CI [-.224, -.011]; and relational resilience, indirect effect size = .13, 95% CI [.036, .329] were found. Brief, empirically tested IPV screens at prenatal clinics may help healthcare providers better identify IPV-exposed patients. Clinical interventions targeting prenatal mental health and relational resilience may help improve labor outcomes for IPV-exposed mothers.
亲密伴侣暴力 (IPV) 在怀孕期间和之前与更高的妊娠并发症和早产发生率有关。然而，据我们所知，没有研究探讨产前心理健康问题和关系韧性作为过去一年 IPV 暴露影响妊娠和分娩的平行机制。本研究旨在：(a) 检查 IPV 暴露对妊娠并发症和早产的贡献，控制儿童期逆境；(b) 评估产前心理健康和关系韧性作为 IPV 暴露对妊娠并发症和早产影响的中介。我们假设 IPV 将预测更高水平的心理健康问题和更低水平的关系韧性，这两者都将增加女性分娩并发症的风险，因此更少的心理健康问题和更高的关系韧性将与更少的妊娠并发症和早产相关。参与者在怀孕期间和分娩后 6 周接受了访谈。未发现 IPV 暴露对妊娠并发症或分娩并发症有直接影响。通过产前心理健康对分娩的 IPV 平行间接影响，间接效应量 = -.09；95%CI [-.224，-.011]；和关系韧性，间接效应量 =.13，95%CI [.036，.329]。在产前诊所进行简短的、经过实证检验的 IPV 筛查可能有助于医疗保健提供者更好地识别 IPV 暴露的患者。针对产前心理健康和关系韧性的临床干预可能有助于改善 IPV 暴露母亲的分娩结局。
