探讨妊娠期亲密伴侣暴力与死胎的关系。

Exploring the relationship between intimate partner violence during pregnancy and stillbirths.

机构信息

Johns Hopkins University-Pakistan Fogarty International Collaborative Trauma and Injury Research Training Program, Johns Hopkins International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD 21205, USA.

Department of Community Health Sciences, Aga Khan University, National Stadium Rd, Karachi 74800, Sindh, Pakistan.

出版信息

Injury. 2023 Aug;54 Suppl 4(Suppl 4):110477. doi: 10.1016/j.injury.2022.11.020.

DOI:10.1016/j.injury.2022.11.020

PMID:37573063

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10426518/

Abstract

INTRODUCTION

The relationship between intimate partner violence (IPV) in pregnancy and stillbirths is poorly understood. We aimed to determine if there was any association between stillbirths and IPV during pregnancy.

METHODS

A community-based, matched, case-control study was conducted in 2014, nested within the Maternal and Newborn Health Registry of the Global Network for Women's and Children's Health Research in Pakistan. Using a WHO questionnaire, IPV in pregnancy was ascertained from 256 cases (women with stillbirths) and 539 controls (women with live births), individually matched on parity. Multivariable conditional logistic regression analysis assessed the association of IPV in pregnancy ending in stillbirths compared to those with live births.

RESULTS

The effect of physical and psychological IPV was modified by maternal age. Among women 25-34 years old with stillbirths, the odds of experiencing physical IPV in pregnancy were four times greater than those with live births, after controlling for confounders [odds ratio 4.1 (95% CI: 1.5, 11.2)]. A negative association was observed between psychological IPV in pregnancy and stillbirths among women younger than 25 years, and no association was observed between sexual IPV during pregnancy and stillbirths.

CONCLUSION

Study results show that women 25-34 years of age with stillbirths were four times more likely to experience physical IPV during pregnancy. Further studies replicating the effect modification of IPV by maternal age are warranted.

摘要

引言

妊娠期间亲密伴侣暴力（IPV）与死胎之间的关系尚未被充分理解。我们旨在确定死胎与妊娠期间的 IPV 是否存在关联。

方法

2014 年，在巴基斯坦全球妇女儿童健康研究网络的母婴健康登记处内，进行了一项基于社区的匹配病例对照研究。使用世界卫生组织问卷，从 256 例（死胎产妇）和 539 例（活产产妇）病例和对照中分别确定了妊娠期间的 IPV，这些产妇按照产次进行了个体匹配。多变量条件逻辑回归分析评估了妊娠期间 IPV 与死胎的关联，与活产进行比较。

结果

物理和心理 IPV 的影响受到产妇年龄的调节。在 25-34 岁的死胎产妇中，在控制混杂因素后，经历孕期物理 IPV 的可能性是活产产妇的四倍[比值比 4.1（95%置信区间：1.5, 11.2)]。在年龄小于 25 岁的孕妇中，观察到孕期心理 IPV 与死胎之间呈负相关，而孕期性 IPV 与死胎之间无关联。