Department of Obstetrics and Gynecology, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Mail Code L-466, Portland, OR, 97239, USA.
Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR, USA.
Arch Gynecol Obstet. 2024 Nov;310(5):2515-2522. doi: 10.1007/s00404-024-07720-x. Epub 2024 Sep 3.
To examine the association between physical, sexual, or physiological harm in pregnancy and perinatal outcomes in a large, contemporary birth cohort.
This retrospective cohort study used California-linked vital statistics and hospital discharge data from 2016 to 2020. We included singleton, non-anomalous births with a gestational age of 23-42 weeks. Violence in pregnancy was identified using International Classification of Disease, Tenth Revision (ICD-10) codes. Chi-square tests and multivariable Poisson regression models were used to evaluate associations of violence in pregnancy with perinatal outcomes.
A total of 1,728,478 pregnancies met inclusion criteria, of which 3,457 (0.2%) had reported violence in pregnancy. Compared to those without violence in pregnancy, individuals who experienced violence had an increased risk of non-severe hypertensive disorders (aRR = 1.36, 95% CI 1.22, 1.51), preeclampsia with severe features (aRR = 1.34; 95% CI 1.11, 1.61), chorioamnionitis (aRR = 1.68; 95% CI 1.48, 1.91), anemia (aRR = 1.59; 95% CI 1.50, 1.68), antepartum hemorrhage (aRR = 2.17; 95% CI 1.19, 3.95), and postpartum hemorrhage (aRR = 1.65; 95% CI 1.48, 1.85). Violence in pregnancy was also associated with increased risk of Apgar score < 7 at 5 min (aRR = 1.37; 95% CI 1.11, 1.71) and neonatal hypoglycemia (aRR = 1.26; 95% CI 1.07, 1.48).
Violence experienced in pregnancy is associated with an increased risk of adverse perinatal outcomes. Understanding how universal screening and early recognition of violence in pregnancy may reduce disparities in maternal morbidity for this understudied population is critical.
在一个大型的当代出生队列中，研究妊娠期间身体、性或生理伤害与围产期结局之间的关联。
本回顾性队列研究使用了 2016 年至 2020 年加利福尼亚州关联的生命统计数据和医院出院数据。我们纳入了孕龄为 23-42 周的单胎、非畸形分娩。使用国际疾病分类第 10 版（ICD-10）编码识别妊娠期间的暴力行为。卡方检验和多变量泊松回归模型用于评估妊娠期间的暴力行为与围产期结局之间的关联。
共有 1728478 例妊娠符合纳入标准，其中 3457 例（0.2%）报告了妊娠期间的暴力行为。与未经历妊娠暴力的个体相比，经历过暴力的个体发生非严重高血压疾病的风险增加（ARR=1.36，95%CI 1.22，1.51）、子痫前期伴严重特征（ARR=1.34；95%CI 1.11，1.61）、绒毛膜羊膜炎（ARR=1.68；95%CI 1.48，1.91）、贫血（ARR=1.59；95%CI 1.50，1.68）、产前出血（ARR=2.17；95%CI 1.19，3.95）和产后出血（ARR=1.65；95%CI 1.48，1.85）。妊娠期间的暴力行为也与 5 分钟时 Apgar 评分<7 的风险增加相关（ARR=1.37；95%CI 1.11，1.71）和新生儿低血糖的风险增加相关（ARR=1.26；95%CI 1.07，1.48）。
妊娠期间经历的暴力行为与不良围产期结局的风险增加有关。了解如何对妊娠期间的暴力行为进行普遍筛查和早期识别，可能会减少对这一研究不足的人群中产妇发病率的差异，这一点至关重要。
