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在一个众包的全国样本中,与近期生殖胁迫和亲密伴侣暴力相关的妊娠、分娩及心理健康结局

Pregnancy, Birth, and Mental Health Outcomes Associated With Recent Reproductive Coercion and Intimate Partner Violence in a Crowd-Sourced National Sample.

作者信息

Trister Grace Karen, Gupta Jhumka, Fay Kathryn, Altay Tara, Kanselaar Samantha, Miller Elizabeth

机构信息

School of Nursing, George Mason University, Fairfax, Virginia.

Department of Global & Community Health, George Mason University, Fairfax, Virginia.

出版信息

J Midwifery Womens Health. 2025 May 19. doi: 10.1111/jmwh.13758.

Abstract

INTRODUCTION

Reproductive coercion (RC) is a type of intimate partner violence (IPV) in which partners control reproductive health decision-making. More evidence is needed on peripartum health outcomes related to RC, with and without IPV, to inform interventions and health care response. The purpose of this study was to determine the impact of RC, with and without other forms of IPV, on pregnancy, birth, and mental health outcomes in a sample of people who were currently or recently pregnant.

METHODS

We conducted a cross-sectional survey with people who had been pregnant in the past 2 years (N = 1941). Logistic regression models examined predicted outcomes with RC as a primary exposure and explored combinations of RC and IPV.

RESULTS

A total of 23.8% of the sample reported any past-2-years RC. RC was significantly associated with most pregnancy, birth, neonatal, and mental health outcomes. People who experienced RC alone had 2.44 higher odds of having a low birth weight newborn (95% CI, 1.04-5.71) and 1.78 higher odds of postpartum depression (95% CI, 1.03-3.08) compared with people who did not experience RC or IPV. RC with other forms of IPV had a significant impact on suicidality even controlling for depression and anxiety (odds ratio, 2.85; 95% CI, 1.94-4.18), compared with those who did not experience either.

DISCUSSION

Our findings underscore the importance of studying RC as its own construct due to its clear, independent impact on maternal health outcomes. RC, with and without physical violence, is common and detrimental to the health of pregnant and postpartum people. Greater attention to mechanisms for these associations (and the disproportionate burden on populations experiencing marginalization) is needed to interrupt and prevent harmful downstream effects.

摘要

引言

生殖胁迫(RC)是亲密伴侣暴力(IPV)的一种形式,即伴侣控制生殖健康决策。需要更多关于与生殖胁迫相关的围产期健康结果的证据,无论是否存在亲密伴侣暴力,以便为干预措施和医疗保健应对提供信息。本研究的目的是确定生殖胁迫(无论是否伴有其他形式的亲密伴侣暴力)对当前或近期怀孕人群样本的妊娠、分娩和心理健康结果的影响。

方法

我们对过去两年内怀孕的人群(N = 1941)进行了横断面调查。逻辑回归模型以生殖胁迫作为主要暴露因素来检验预测结果,并探讨生殖胁迫与亲密伴侣暴力的组合情况。

结果

共有23.8%的样本报告在过去两年内经历过生殖胁迫。生殖胁迫与大多数妊娠、分娩、新生儿和心理健康结果显著相关。与未经历生殖胁迫或亲密伴侣暴力的人相比,仅经历生殖胁迫的人出生低体重新生儿的几率高2.44倍(95%置信区间,1.04 - 5.71),产后抑郁的几率高1.78倍(95%置信区间,1.03 - 3.08)。与未经历任何一种情况的人相比,伴有其他形式亲密伴侣暴力的生殖胁迫即使在控制了抑郁和焦虑因素后,对自杀倾向仍有显著影响(优势比,2.85;95%置信区间,1.94 - 4.18)。

讨论

我们的研究结果强调了将生殖胁迫作为一个独立概念进行研究的重要性,因为它对孕产妇健康结果有明显的独立影响。无论是否伴有身体暴力,生殖胁迫都很常见,且对怀孕和产后人群的健康有害。需要更加关注这些关联的机制(以及对处于边缘化人群造成的不成比例的负担),以中断和预防有害的下游影响。

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