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孕期及产后亲密伴侣暴力行为及其与抑郁症和围产期健康的关系:一项妊娠队列研究的结果

Intimate partner violence across pregnancy and the postpartum and the relationship to depression and perinatal wellbeing: findings from a pregnancy cohort study.

作者信息

Galbally Megan, Watson Stuart, MacMillan Kelli, Sevar Katherine, Howard Louise M

机构信息

School of Clinical Sciences, Monash University, Clayton, Australia.

Health Futures Institute, Murdoch University, Perth, Australia.

出版信息

Arch Womens Ment Health. 2024 Oct;27(5):807-815. doi: 10.1007/s00737-024-01455-z. Epub 2024 Mar 9.

Abstract

PURPOSE

To compare the prevalence of emotional and physical intimate partner violence (IPV) across pregnancy and the first year postpartum in those with and without clinical depression and assess the association between maternal childhood trauma, current stressful life events and depression and IPV over the perinatal period.

METHODS

Data were obtained from 505 pregnant women from the Mercy Pregnancy and Emotional Wellbeing Study (MPEWS), a cohort study with data collected across pregnancy until 12 months postpartum. Maternal antenatal depression was measured using the Structured Clinical Interview for DSM-IV (SCID-IV) with repeat measurement of perinatal depressive symptoms using the Edinburgh Postnatal Depression Scale (EPDS). Trauma was measured using the Childhood Trauma Questionnaire, and experiences of physical and emotional intimate partner violence using items in the Stressful Life Events Scale.

RESULTS

Women experiencing IPV across the perinatal period were significantly more likely to score over 13 on the EPDS (p < .001) at each timepoint in pregnancy and the postpartum and physical IPV was associated with clinical depression. Further, a history of childhood trauma and current additional stressful life events were significantly associated with reporting current IPV in the perinatal period.

CONCLUSIONS

This study confirmed the risk factors of childhood trauma and current stressful life events for reporting experiences of IPV in the perinatal period. Furthermore, women experiencing IPV reported higher depressive symptoms, providing evidence supporting the value of assessing those women who screen higher on the EPDS for IPV. Together these findings also support trauma informed care across pregnancy and the postpartum.

摘要

目的

比较患有和未患有临床抑郁症的女性在孕期及产后第一年遭受情感和身体亲密伴侣暴力(IPV)的发生率,并评估孕产妇童年创伤、当前压力性生活事件以及抑郁症与围产期IPV之间的关联。

方法

数据来自“梅西孕期与情绪健康研究”(MPEWS)中的505名孕妇,这是一项队列研究,收集了从孕期到产后12个月的数据。使用《精神疾病诊断与统计手册》第四版(DSM-IV)结构化临床访谈来测量孕产妇产前抑郁症,并使用爱丁堡产后抑郁量表(EPDS)对围产期抑郁症状进行重复测量。使用儿童创伤问卷来测量创伤,使用压力性生活事件量表中的项目来测量身体和情感亲密伴侣暴力的经历。

结果

在孕期和产后的每个时间点,经历围产期IPV的女性在EPDS上得分超过13的可能性显著更高(p < 0.001),并且身体IPV与临床抑郁症相关。此外,童年创伤史和当前额外的压力性生活事件与报告围产期当前的IPV显著相关。

结论

本研究证实了童年创伤和当前压力性生活事件是围产期报告IPV经历的风险因素。此外,经历IPV的女性报告了更高的抑郁症状,这为评估那些在EPDS上得分较高的女性是否遭受IPV提供了支持证据。这些发现共同支持了贯穿孕期和产后的创伤知情护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a6dc/11405469/f0c21c51e456/737_2024_1455_Fig1_HTML.jpg

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