Department of Health & Society, University of Toronto Scarborough, the Dalla Lana School of Public Health, the Edwin S.H. Leong Centre for Healthy Children, the Department of Pediatrics, and the Department of Psychiatry, University of Toronto, ICES, the Women's College Research Institute, Women's College Hospital, the Hospital for Sick Children, the Li Ka Shing Knowledge Institute, St. Michael's Hospital, and the Azrieli Adult Neurodevelopmental Centre, Centre for Addiction & Mental Health, Toronto, Ontario, Canada; the Center for Psychiatry and Behavioral Health, Wexner Medical Center, The Ohio State University, Columbus, Ohio; and the College of Health Professions, Virginia Commonwealth University, Richmond, Virginia.
Obstet Gynecol. 2022 Nov 1;140(5):797-805. doi: 10.1097/AOG.0000000000004950. Epub 2022 Oct 5.
To compare the risk of interpersonal violence experienced by pregnant and postpartum individuals with physical disabilities, sensory disabilities, or intellectual or developmental disabilities with those without disabilities, and to examine whether a prepregnancy history of interpersonal violence puts individuals with disabilities, at excess risk of interpersonal violence in the perinatal period.
This population-based study included all individuals aged 15-49 years with births in Ontario, Canada, from 2004 to 2019. Individuals with physical (n=147,414), sensory (n=47,459), intellectual or developmental (n=2,557), or multiple disabilities (n=9,598) were compared with 1,594,441 individuals without disabilities. The outcome was any emergency department visit, hospital admission, or death related to physical, sexual, or psychological violence between fertilization and 365 days postpartum. Relative risks (RRs) were adjusted for baseline social and health characteristics. Relative excess risk due to interaction (RERI) was estimated from the joint effects of disability and prepregnancy violence history; RERI>0 indicated positive interaction.
Individuals with physical (0.8%), sensory (0.7%), intellectual or developmental (5.3%), or multiple disabilities (1.8%) were more likely than those without disabilities (0.5%) to experience perinatal interpersonal violence. The adjusted RR was 1.40 (95% CI 1.31-1.50) in those with physical disabilities, 2.39 (95% CI 1.98-2.88) in those with intellectual or developmental disabilities, and 1.96 (95% CI 1.66-2.30) in those with multiple disabilities. Having both a disability and any violence history produced a positive interaction for perinatal interpersonal violence (adjusted RERI 0.87; 95% CI 0.47-1.29).
The perinatal period is a time of relative high risk for interpersonal violence among individuals with pre-existing disabilities, especially those with a history of interpersonal violence.
比较患有身体残疾、感官残疾、智力或发育残疾以及无残疾的孕妇和产后个体经历人际暴力的风险，并探讨孕前人际暴力史是否使残疾个体在围产期面临过度人际暴力风险。
本基于人群的研究纳入了 2004 年至 2019 年期间在加拿大安大略省分娩的所有 15-49 岁个体。将患有身体（n=147414）、感官（n=47459）、智力或发育（n=2557）或多重残疾（n=9598）的个体与 1594441 名无残疾个体进行比较。结局为受精至产后 365 天内与身体、性或心理暴力有关的任何急诊就诊、住院或死亡。相对风险（RR）根据基线社会和健康特征进行调整。相对超额交互作用风险（RERI）根据残疾和孕前暴力史的联合效应估计；RERI＞0 表示存在正交互作用。
与无残疾个体（0.5%）相比，患有身体残疾（0.8%）、感官残疾（0.7%）、智力或发育残疾（5.3%）或多重残疾（1.8%）的个体更有可能经历围产期人际暴力。身体残疾个体的调整 RR 为 1.40（95%CI 1.31-1.50），智力或发育残疾个体为 2.39（95%CI 1.98-2.88），多重残疾个体为 1.96（95%CI 1.66-2.30）。同时存在残疾和任何暴力史会导致围产期人际暴力产生正交互作用（调整 RERI 0.87；95%CI 0.47-1.29）。
围产期是患有先前存在残疾的个体，特别是有过人际暴力史的个体发生人际暴力的相对高风险时期。
