VHA VISN 17 Center of Excellence for Research on Returning War Veterans and the Central Texas Veterans Health Care System, Waco, USA.
Department of Psychiatry, Dell Medical School of the University of Texas at Austin, Austin, USA.
J Gen Intern Med. 2021 Oct;36(10):2982-2988. doi: 10.1007/s11606-020-06498-3. Epub 2021 Jan 19.
Intimate partner violence (IPV) is a prevalent and serious health concern for women veterans, associated with mental and physical health symptoms. The adverse impacts of IPV are exacerbated during pregnancy, with added risks for pregnancy and postpartum outcomes.
Identify the scope of IPV among pregnant veterans and associations with health outcomes.
Data were obtained from a national retrospective cohort study.
Study participants were 442 pregnant veterans using VHA maternity care benefits.
Mental health history was assessed via self-report measure and chart review; history of IPV and perinatal depression were assessed via brief validated self-report measures.
Fourteen percent of the sample reported past-year IPV. Report of past-year IPV was associated with higher self-reported rates of lifetime mental health disorders including depression (p = 0.01), posttraumatic stress disorder (p = 0.02), anxiety disorders (p = 0.05), mood disorders (p = 0.01), bipolar disorder (p = 0.001), and eating disorders (p = 0.003); past-year IPV was also associated with the diagnosis of posttraumatic stress disorder during pregnancy (p = 0.002). Additionally, past-year IPV was associated with higher rates of military sexual trauma (MST; p = 0.03), pregnancy health risk behaviors (i.e., smoking, alcohol, and drug use; p = 0.004), greater number of VHA mental health visits during pregnancy (p = 0.04), and a lower likelihood of seeking social support from a spouse or partner (p < 0.0001).
Results indicate substantial rates of IPV among pregnant veterans, and high rates of mental health conditions which may be exacerbated by MST experience and lower likelihood of seeking social support. Clinicians treating pregnant veterans should screen for and address IPV and mental health treatment needs, and risks should be assessed among pregnant veterans experiencing IPV.
亲密伴侣暴力（IPV）是女性退伍军人普遍存在且严重的健康问题，与心理健康和身体健康症状有关。在怀孕期间，IPV 的不利影响会加剧，并增加妊娠和产后结局的风险。
确定怀孕退伍军人中 IPV 的范围以及与健康结果的关联。
数据来自一项全国性回顾性队列研究。
本研究的参与者是 442 名使用退伍军人事务部生育保健福利的怀孕退伍军人。
通过自我报告评估心理健康史；通过简短的经过验证的自我报告评估 IPV 和围产期抑郁的病史。
样本中有 14%的人报告了过去一年的 IPV。过去一年报告的 IPV 与更高的自我报告终生心理健康障碍率相关，包括抑郁（p = 0.01）、创伤后应激障碍（p = 0.02）、焦虑障碍（p = 0.05）、心境障碍（p = 0.01）、双相情感障碍（p = 0.001）和饮食障碍（p = 0.003）；过去一年的 IPV 也与怀孕期间创伤后应激障碍的诊断相关（p = 0.002）。此外，过去一年的 IPV 与更高的军事性创伤（MST）发生率相关（p = 0.03）、妊娠健康风险行为（即吸烟、饮酒和吸毒；p = 0.004）、怀孕期间 VHA 心理健康就诊次数更多（p = 0.04）以及更不可能向配偶或伴侣寻求社会支持（p < 0.0001）。
结果表明，怀孕退伍军人中存在相当高的 IPV 率，以及心理健康状况的高发生率，这些状况可能因 MST 经历而加剧，并且更不可能寻求社会支持。治疗怀孕退伍军人的临床医生应筛查和解决 IPV 和心理健康治疗需求，并应评估经历 IPV 的怀孕退伍军人的风险。
