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反复暴力、伴有并发症的暴力行为和针对孕妇及哺乳期妇女的亲密伴侣暴力与母乳喂养持续时间的关系。

Recurrent Violence, Violence with Complications, and Intimate Partner Violence Against Pregnant Women and Breastfeeding Duration.

机构信息

Department of Medicine III, Federal University of Maranhão, São Luís, Brazil.

Department of Public Health, Federal University of Maranhão, São Luís, Brazil.

出版信息

J Womens Health (Larchmt). 2021 Jul;30(7):979-989. doi: 10.1089/jwh.2020.8378. Epub 2020 Sep 16.

Abstract

Few studies have investigated the association between violence against pregnant women in terms of recurrence, complications, and perpetrators of violence, and breastfeeding duration. This study verifies whether recurrent violence, violence with pregnancy complications, and intimate partner violence (IPV) against pregnant women are associated with shorter exclusive breastfeeding up to the infant's 6th month and breastfeeding up to the 12th month of life. A cohort study with a convenience sample of 1,146 pregnant women was performed. Follow-up assessments were conducted at birth, and at 12-36 months. Survival analysis was used to verify whether recurrent violence, violence with pregnancy complications, and IPV were associated with reduced duration of exclusive breastfeeding and breastfeeding. The adjusted Cox regression revealed no difference regarding exclusive breastfeeding duration among mothers exposed or not exposed to violence and according to who perpetrated the violence. The risk of an infant not being breastfed within the first 12 months of life increased in cases of violence before/during pregnancy (95% confidence interval [CI] = 1.03-1.88), recurrent psychological/physical/sexual violence during pregnancy (95% CI = 1.11-1.92), recurrent psychological violence (95% CI = 1.05-1.96), and recurrent physical/sexual violence (95% CI = 1.01-2.39). Violence with pregnancy complications (95% CI = 0.94-2.22) was not associated with breastfeeding interruption. Similar risks of breastfeeding interruption were observed for IPV (95% CI = 0.96-1.87) and violence perpetrated by other family members (95% CI = 0.83-1.89). We observed a shorter breastfeeding duration up to 12 months of life in cases of recurrent violence.

摘要

很少有研究调查过针对孕妇的暴力行为(包括暴力行为的复发、并发症和施害者)与母乳喂养持续时间之间的关系。本研究旨在验证孕妇遭受的暴力行为复发、妊娠并发症相关的暴力行为和亲密伴侣暴力(IPV)是否与婴儿 6 月龄前的纯母乳喂养时长和 12 月龄内的母乳喂养时长较短有关。采用方便抽样法对 1146 名孕妇进行了队列研究。在分娩时、12-36 月龄时进行随访评估。采用生存分析来验证暴力行为复发、妊娠并发症相关的暴力行为和 IPV 是否与纯母乳喂养和母乳喂养持续时间缩短有关。调整后的 Cox 回归分析显示,暴露于暴力或未暴露于暴力的母亲之间以及暴力施害者之间的纯母乳喂养时长无差异。在妊娠前/期间发生暴力(95%置信区间 [CI] = 1.03-1.88)、妊娠期反复发生心理/身体/性暴力(95% CI = 1.11-1.92)、反复发生心理暴力(95% CI = 1.05-1.96)和反复发生身体/性暴力(95% CI = 1.01-2.39)的情况下,婴儿在 12 个月内未进行母乳喂养的风险增加。妊娠并发症相关的暴力行为(95% CI = 0.94-2.22)与母乳喂养中断无关。IPV(95% CI = 0.96-1.87)和其他家庭成员实施的暴力(95% CI = 0.83-1.89)导致母乳喂养中断的风险相似。我们观察到,在反复发生暴力的情况下,母乳喂养时长至 12 个月时较短。

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