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童年期虐待和产前亲密伴侣暴力对分娩经历和母乳喂养结果的影响。

The influence of childhood abuse and prenatal intimate partner violence on childbirth experiences and breastfeeding outcomes.

机构信息

Queensland University of Technology (QUT), Faculty of Health, School of Public Health and Social Work, Brisbane, Australia; Institute of Health Economics and Technology, Hanoi, Viet Nam.

Institute for Community Health Research, University of Medicine and Pharmacy, Hue University, Hue City, Viet Nam; Faculty of Public Health, University of Medicine and Pharmacy, Hue University, Hue city, Viet Nam.

出版信息

Child Abuse Negl. 2022 Sep;131:105743. doi: 10.1016/j.chiabu.2022.105743. Epub 2022 Jun 20.

Abstract

BACKGROUND

Despite the detrimental effects and life-course health consequences of violence exposure, relatively few studies have adequate capacity to investigate the evolution of violence from childhood to motherhood.

OBJECTIVE

This study aims to examine the cyclical nature of childhood abuse and prenatal inter-partner violent victimization (p-IPV) and its adverse impact on childbirth trauma and exclusive breastfeeding (EBF) practice in Vietnam.

METHOD

Using a prospective birth cohort, 150 pregnant women were recruited in the third trimester of pregnancy in Hue city in central Vietnam (Wave 1-Baseline) and re-interviewed approximately three months after delivery (Wave 2-Follow-up). The direct and indirect effects of violent victimization on subsequent childbirth experience (measured by Birth Memories and Recall Questionnaire) and EBF practice were estimated by using augmented-inverse-probability-weighted models, sensitivity analysis, and structural equation model.

RESULTS

Detrimental and prolonged effects of the inter-generational cycle of violence transverse childhood to motherhood. Women who experienced either childhood abuse or p-IPV violence were more likely to experience negative emotional childbirth memories [ARR 1.21, 95 % CI (1.04, 1.39)]. Evidence also suggested that not continuing to exclusively breastfeed at 3 months post-partum was strongly associated with prenatal depression, young age, and perceived low social status during pregnancy. Perceived strong connectedness among extended family members and social networks (i.e. nexus among family, friends, and neighborhood) provided a buffering effect by preventing EBF termination.

CONCLUSION

This research provides insights into the protective role of social connectedness in improving breastfeeding practice. It is vital to establish wholistic antenatal care and social service system to offer specialized support and response for victims of violence and mitigate the long-term sequelae of traumatic events.

摘要

背景

尽管暴力暴露会产生有害影响和对整个生命周期健康造成影响,但相对较少的研究有足够的能力来调查暴力从儿童期到母亲期的演变。

目的

本研究旨在检验越南儿童期虐待和产前伴侣间暴力受害(p-IPV)的循环性质及其对分娩创伤和纯母乳喂养(EBF)实践的不良影响。

方法

使用前瞻性出生队列,在越南中部 Hue 市的妊娠晚期招募了 150 名孕妇(第 1 波-基线),并在分娩后大约三个月(第 2 波-随访)再次进行访谈。使用增强逆概率加权模型、敏感性分析和结构方程模型来估计暴力受害对随后分娩体验(通过分娩记忆和回忆问卷测量)和 EBF 实践的直接和间接影响。

结果

暴力的代际循环具有破坏性和长期性影响,贯穿儿童期到母亲期。经历过儿童期虐待或 p-IPV 暴力的女性更有可能经历负面的情绪化分娩记忆[ARR 1.21,95%置信区间(1.04,1.39)]。证据还表明,在产后 3 个月内不继续进行纯母乳喂养与产前抑郁、年龄较小以及怀孕期间感知到的社会地位较低密切相关。扩展家庭成员和社交网络之间的强烈联系(即家庭、朋友和邻里之间的联系)起到了缓冲作用,防止了 EBF 的终止。

结论

这项研究深入了解了社会联系在改善母乳喂养实践方面的保护作用。建立全面的产前保健和社会服务系统至关重要,以为暴力受害者提供专门的支持和应对,并减轻创伤事件的长期后果。

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