Dye T D, Tollivert N J, Lee R V, Kenney C J
Department of Obstetrics and Gynecology, State University of New York, Syracuse 13210.
Paediatr Perinat Epidemiol. 1995 Jan;9(1):35-47. doi: 10.1111/j.1365-3016.1995.tb00117.x.
Few studies have followed pregnant women prospectively to examine the impact of violence on birth outcome. We included such an assessment in a prospective study of pregnancy among low-income women. Nurses and social workers interviewed pregnant women (n = 364) and asked if they had been the object of violence since they became pregnant. These prenatal interviews were linked with information from perinatal records and with birth and death information. In total, 15.9% of women in the study indicated they had been abused since they became pregnant. Abused women were more likely to be teenagers and to have partners who were teenagers. Abused women were more likely to be primiparous, to smoke during pregnancy and to have physical problems related to stress. Women battered during pregnancy were more likely to suffer fetal distress or fetal death [Odds Ratio (OR) 3.68; 95% Confidence Interval (CI) 1.36, 9.94], even after adjusting for maternal age and smoking status. Finally the infants of abused women were more likely to remain in hospital after their mother's discharge (OR: 3.75; 95% CI: 1.38, 10.23). Our findings suggest that fetuses may be compromised in utero, as shown by higher rates of fetal distress and fetal death found among women physically abused during pregnancy.
很少有研究对孕妇进行前瞻性跟踪，以考察暴力对分娩结局的影响。我们在一项针对低收入女性的前瞻性妊娠研究中纳入了这样一项评估。护士和社会工作者对孕妇（n = 364）进行访谈，询问她们自怀孕以来是否遭受过暴力。这些产前访谈与围产期记录信息以及出生和死亡信息相关联。在该研究中，总计15.9%的女性表示自怀孕以来遭受过虐待。受虐女性更有可能是青少年，其伴侣也更有可能是青少年。受虐女性更有可能是初产妇，在孕期吸烟，且有与压力相关的身体问题。孕期遭受殴打的女性更有可能出现胎儿窘迫或胎儿死亡[比值比（OR）3.68；95%置信区间（CI）1.36，9.94]，即使在对产妇年龄和吸烟状况进行调整之后也是如此。最后，受虐女性的婴儿在其母亲出院后更有可能继续住院（OR：3.75；95% CI：1.38，10.23）。我们的研究结果表明，如孕期遭受身体虐待的女性中胎儿窘迫和胎儿死亡发生率较高所示，胎儿在子宫内可能会受到损害。
