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孕期亲密伴侣暴力与子代早期发育:一项前瞻性出生队列研究

Intimate Partner Violence During Pregnancy and Early Offspring Development: A Prospective Birth Cohort Study.

作者信息

Jiang Nan, Ma Shuang-Shuang, Zu Ping, Zhang Lei, Xu Min, Bian Jing-Feng, Xu Ji-Rong, Luo Wei, Wang Hai-Xia, Zhu Dao-Min, Zhu Peng

机构信息

Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China; Ministry of Education Key Laboratory of Population Health Across Life Cycle, Hefei, China; National Health Commission of the People's Republic of China Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China; Anhui Provincial Key Laboratory of Environment and Population Health Across the Life Course, Anhui Medical University, Hefei, China; Center for Big Data and Population Health of Institution of Health and Medical, School of Public Health, Anhui Medical University, Hefei, China.

School of Nursing, Anhui Medical University, Hefei, China.

出版信息

Biol Psychiatry. 2025 Apr 4. doi: 10.1016/j.biopsych.2025.03.020.

Abstract

BACKGROUND

Intimate partner violence (IPV) during pregnancy is linked to several unfavorable outcomes for both mothers and babies. However, few studies have examined its connections to early infant neurodevelopment, and the underlying processes of these connections remain unclear.

METHODS

Our research was conducted within a prospective birth cohort of 3007 mother-child pairs from March 2018 to July 2023. Participants were followed from pregnancy until the offspring were 12 months old. We collected data on IPV during pregnancy, prenatal depression, postpartum depression, umbilical cord blood inflammatory level, and the Ages and Stages Questionnaire, Third Edition (ASQ-3) and used multiple logistic regression analysis to examine the relationship between IPV during pregnancy and children's neurodevelopmental delay.

RESULTS

In our study cohort, 9.8% of pregnant women experienced IPV during pregnancy, and 8.7% experienced psychological violence. Psychological violence was associated with increased relative risks of failure in communication, problem-solving, and personal-social domains of the ASQ-3. The corresponding 95% CIs were 1.95 (1.24-3.07), 2.10 (1.25-3.52), and 1.97 (1.29-3.02), respectively. Moreover, IPV during pregnancy combined with depression further exacerbated these risks. In addition, 19.6% of the association between IPV during pregnancy and prenatal depression was mediated by cord blood inflammatory indices in relation to the ASQ-3 failure risk.

CONCLUSIONS

This prospective birth cohort study indicates that the significant negative impact of psychological violence on the offspring's neurodevelopmental delay depends on the intensity of psychological stress, with umbilical cord blood inflammation being a potential underlying biological mechanism.

摘要

背景

孕期亲密伴侣暴力(IPV)与母亲和婴儿的多种不良结局相关。然而,很少有研究探讨其与早期婴儿神经发育的联系,且这些联系的潜在机制仍不清楚。

方法

我们的研究在2018年3月至2023年7月的3007对母婴前瞻性出生队列中进行。参与者从孕期开始随访至其后代12个月大。我们收集了孕期IPV、产前抑郁、产后抑郁、脐带血炎症水平以及《年龄与发育阶段问卷》第三版(ASQ-3)的数据,并使用多元逻辑回归分析来研究孕期IPV与儿童神经发育迟缓之间的关系。

结果

在我们的研究队列中,9.8%的孕妇在孕期经历了IPV,8.7%经历了心理暴力。心理暴力与ASQ-3沟通、问题解决和个人社交领域失败的相对风险增加相关。相应的95%置信区间分别为1.95(1.24 - 3.07)、2.10(1.25 - 3.52)和1.97(1.29 - 3.02)。此外,孕期IPV合并抑郁进一步加剧了这些风险。另外,在与ASQ-3失败风险相关方面,孕期IPV与产前抑郁之间19.6%的关联由脐带血炎症指标介导。

结论

这项前瞻性出生队列研究表明,心理暴力对后代神经发育迟缓的显著负面影响取决于心理压力强度大小,脐带血炎症是一种潜在的生物学机制。

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