Murdoch Children's Research Institute, Australia; University of Melbourne, Australia; South Australian Health and Medical Research Institute, Australia.
Murdoch Children's Research Institute, Australia; University of Melbourne, Australia; Royal Children's Hospital, Australia.
J Affect Disord. 2020 Feb 1;262:247-257. doi: 10.1016/j.jad.2019.11.015. Epub 2019 Nov 5.
We aimed to assess the relationship between intimate partner violence (IPV) and maternal mental health ten years after a first birth METHODS: 1507 first-time mothers completed questionnaires at 3, 6, 12 and 18 months postpartum and 4 and ten years post the index birth. Exposure to IPV was assessed using the Composite Abuse Scale at 1, 4 and ten years. Standardised measures of depressive (CES-D), anxiety (BAI) and post-traumatic stress symptoms (PCL-C) were completed at ten-year follow-up.
One in three (34%) women experienced IPV between the birth of their first child and their child turning 10. For the one in six women (18.6%) who experienced IPV in the year prior to ten-year follow-up, the prevalence of depressive symptoms was 38.9% compared with 14.2% for women who never reported IPV (adjusted odds ratio [AdjOR] 2.9, 95% confidence interval [CI] 1.9-4.5). Prevalence of anxiety symptoms was 28.1% compared with 8.5% (AdjOR 3.4, 95% CI 2.0-5.9); and prevalence of post-traumatic stress symptoms was 41.9% compared with 11.3% (AdjOR 4.9, 95% CI 3.0-7.9).
Mental health symptoms and exposure to IPV were assessed by self-report and may be subject to misclassification bias as a result of non-disclosure.
The high prevalence of mental health symptoms among women exposed to IPV in the ten years after giving birth coupled with the extent of post-traumatic stress symptoms and co-morbid mental health symptoms reinforce the need to provide appropriate care and referral pathways to women in the decade after having a baby. Recognition of the context of IPV and nature of mental health concerns is needed in tailoring responses.
我们旨在评估首次分娩后十年内亲密伴侣暴力（IPV）与产妇心理健康之间的关系。
1507 名初产妇在产后 3、6、12 和 18 个月以及指数分娩后 4 年和 10 年完成了问卷调查。在 1、4 和 10 年时使用复合虐待量表评估 IPV 的暴露情况。在 10 年随访时完成了抑郁（CES-D）、焦虑（BAI）和创伤后应激症状（PCL-C）的标准化测量。
在孩子 10 岁之前，三分之一（34%）的女性经历过 IPV。对于在 10 年随访前一年经历过 IPV 的六分之一女性（18.6%），抑郁症状的患病率为 38.9%，而从未报告过 IPV 的女性为 14.2%（调整后的优势比[AdjOR] 2.9，95%置信区间[CI] 1.9-4.5）。焦虑症状的患病率为 28.1%，而从未报告过 IPV 的女性为 8.5%（AdjOR 3.4，95% CI 2.0-5.9）；创伤后应激症状的患病率为 41.9%，而从未报告过 IPV 的女性为 11.3%（AdjOR 4.9，95% CI 3.0-7.9）。
心理健康症状和 IPV 的暴露情况均通过自我报告评估，可能由于未披露而导致分类偏倚。
在分娩后十年内，暴露于 IPV 的女性中出现心理健康症状的高患病率，加上创伤后应激症状的严重程度和合并的心理健康症状，都强调了在生育后十年内为女性提供适当的护理和转诊途径的必要性。在制定应对措施时，需要认识到 IPV 的背景和心理健康问题的性质。
