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母婴亲密伴侣暴力经历与儿童营养结局之间的联系:快速证据评估。

Linkages between maternal experience of intimate partner violence and child nutrition outcomes: A rapid evidence assessment.

机构信息

Department of Epidemiology, Columbia University, New York City, New York, United States of America.

Department of Epidemiology and Pediatrics, Columbia University Irving Medical Center, New York City, New York, United States of America.

出版信息

PLoS One. 2024 Mar 18;19(3):e0298364. doi: 10.1371/journal.pone.0298364. eCollection 2024.

Abstract

BACKGROUND

A strong evidence base indicates that maternal caregivers' experience of intimate partner violence [IPV] impacts children's health, cognitive development, and risk-taking behaviors. Our objective was to review peer-reviewed literature describing the associations between a child's indirect exposure to IPV and corresponding nutrition outcomes, with a particular focus on fragile settings in low and middle-income countries [LMICs].

METHODS

We conducted a rapid evidence assessment to synthesize quantitative associations between maternal caregivers' IPV experience and children's nutrition/growth outcomes (birthweight, feeding, and growth indicators). We included peer-reviewed research, published in English or Spanish after the year 2000, conducted in fragile settings in LMICs.

RESULTS

We identified 86 publications that fit inclusion criteria. Amongst all associations assessed, a maternal caregiver's experience of combined forms of IPV (physical, sexual and emotional) or physical IPV only, were most consistently associated with lower birthweight, especially during pregnancy. Women of child-bearing age, including adolescents, exposed to at least one type of IPV showed a decreased likelihood of following recommended breastfeeding practices. Lifetime maternal experience of combined IPV was significantly associated with stunting among children under 5 years of age in the largest study included, though findings in smaller studies were inconsistent. Maternal experience of physical or combined IPV were inconsistently associated with underweight or wasting in the first five years. Maternal experience of sexual IPV during pregnancy appeared to predict worsened lipid profiles among children.

CONCLUSION

Maternal caregivers' experience of IPV is significantly associated with low birthweight and suboptimal breastfeeding practices, whereas studies showed inconsistent associations with child growth indicators or blood nutrient levels. Future research should focus on outcomes in children aged 2 years and older, investigation of feeding practices beyond breastfeeding, and examination of risk during time periods physiologically relevant to the outcomes. Programmatic implications include incorporation of GBV considerations into nutrition policies and programming and integrating GBV prevention and response into mother and child health and nutrition interventions in LMIC contexts.

摘要

背景

大量证据表明,产妇遭受亲密伴侣暴力(IPV)会影响儿童的健康、认知发展和冒险行为。我们的目标是回顾描述儿童间接接触 IPV 与相应营养结果之间关联的同行评议文献,特别关注中低收入国家(LMIC)的脆弱环境。

方法

我们进行了快速证据评估,以综合产妇 IPV 经历与儿童营养/生长结果(出生体重、喂养和生长指标)之间的定量关联。我们纳入了发表在英语或西班牙语、于 2000 年后在脆弱环境中进行的同行评议研究。

结果

我们确定了 86 篇符合纳入标准的出版物。在评估的所有关联中,产妇经历过综合形式的 IPV(身体、性和情感)或仅身体 IPV 与较低的出生体重最密切相关,尤其是在怀孕期间。至少经历过一种类型 IPV 的育龄妇女,包括青少年,更有可能不遵循推荐的母乳喂养做法。在纳入的最大研究中,一生中经历过综合 IPV 的母亲与 5 岁以下儿童的发育迟缓显著相关,而较小研究的结果则不一致。母亲经历过身体或综合 IPV 与 5 岁以下儿童的消瘦或消瘦程度之间的关联不一致。怀孕期间的性 IPV 经历似乎预示着儿童的血脂谱恶化。

结论

产妇遭受 IPV 与低出生体重和不适当的母乳喂养做法显著相关,而研究表明与儿童生长指标或血液营养水平的关联不一致。未来的研究应侧重于 2 岁及以上儿童的结果,调查母乳喂养以外的喂养行为,并研究与结果在生理上相关的时间段内的风险。方案影响包括将性别暴力问题纳入营养政策和方案,并将性别暴力预防和应对纳入中低收入国家的母婴健康和营养干预措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b24/10947923/2fa0e4677aaa/pone.0298364.g001.jpg

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