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儿童期虐待与围产期并发症:官方健康数据的范围综述。

Childhood Maltreatment and Perinatal Complications: A Scoping Review of Official Health Data.

机构信息

McGill University, Montréal, QC, Canada.

出版信息

Trauma Violence Abuse. 2024 Dec;25(5):4130-4142. doi: 10.1177/15248380241270017. Epub 2024 Aug 19.

Abstract

Child maltreatment (CM) poses significant risks to victims, resulting in enduring physical, psychological, and developmental consequences. Adult survivors of CM seem especially vulnerable to perinatal complications. However, existing research on perinatal outcomes presents mixed results and relies heavily on self-reported data, which may not align with official medical data. Hence, a systematic review using official health data may provide clarity on this association; it may orient future research and the provision of perinatal services. This scoping review aimed to synthesize and evaluate the quality of the literature that utilizes official health data to explore associations between CM and perinatal complications. Following Arksey and O'Malley's model, searches across four databases (PsycINFO, MEDLINE, Scopus, and ProQuest Dissertations/Thesis) produced 8,870 articles. After screening, 23 articles met the inclusion criteria (e.g., recorded perinatal complications using official health data, and peer-reviewed studies or dissertation). Evidence indicates CM survivors have less prenatal care visits, more fetal loss and preterm births, lower gestational age, and increases in emergency cesarean sections. Adults had more cervical insufficiency, lower episiotomies and sphincter ruptures, and overall pregnancy and postpartum complications while adolescents had lower Apgar scores. No associations were observed on other outcomes (e.g., vaginal bleeding, group B streptococcus, and fetal distress). Mixed findings emerged for other perinatal and maternal health concerns such as birth weight and blood pressure. CM survivors may face an increased risk of experiencing perinatal complications. Findings point to the relevance of leveraging health data for CM research and adopting trauma-informed practices in perinatal services.

摘要

儿童虐待(CM)对受害者构成重大风险,导致持久的身体、心理和发育后果。CM 的成年幸存者似乎特别容易受到围产期并发症的影响。然而,现有的围产期结局研究结果喜忧参半,并且严重依赖于自我报告的数据,这些数据可能与官方医疗数据不一致。因此,使用官方健康数据进行系统审查可能会澄清这种关联;它可能会指导未来的研究和围产期服务的提供。本范围审查旨在综合和评估利用官方健康数据探索 CM 与围产期并发症之间关联的文献质量。根据 Arksey 和 O'Malley 的模型,在四个数据库(PsycINFO、MEDLINE、Scopus 和 ProQuest Dissertations/Thesis)中进行了搜索,共产生了 8870 篇文章。经过筛选,23 篇文章符合纳入标准(例如,使用官方健康数据记录围产期并发症,以及同行评审的研究或论文)。有证据表明,CM 幸存者的产前护理次数较少,胎儿丢失和早产较多,胎龄较低,急诊剖宫产次数增加。成年人的宫颈机能不全、会阴切开术和括约肌破裂发生率较低,整体妊娠和产后并发症发生率较高,而青少年的阿普加评分较低。其他结局(例如阴道出血、B 组链球菌和胎儿窘迫)没有观察到关联。其他围产期和母婴健康问题(例如出生体重和血压)的研究结果喜忧参半。CM 幸存者可能面临更高的围产期并发症风险。这些研究结果表明,利用健康数据进行 CM 研究以及在围产期服务中采用创伤知情实践具有重要意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b361/11545123/2eeb7ddf6d48/10.1177_15248380241270017-fig1.jpg

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