Berenson A B, Wiemann C M, Wilkinson G S, Jones W A, Anderson G D
Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston 77555-0587.
Am J Obstet Gynecol. 1994 Jun;170(6):1760-6; discussion 1766-9. doi: 10.1016/s0002-9378(94)70352-3.
We investigated whether physical assault is independently associated with an adverse obstetric outcome.
We compared the perinatal outcomes of 32 indigent women who reported being physically abused during pregnancy with those of 352 control subjects who denied ever being assaulted. Patients were classified into the appropriate category on the basis of a structured interview. Logistic regression analyses were performed to estimate the relative risk of adverse outcome while adjusting for confounders.
Women assaulted in the current pregnancy were twice as likely to have preterm labor as compared with those who denied assault. In addition, crude odds ratios showed a twofold increased risk of chorioamnionitis in assault victims. No difference between abused and nonabused women was noted in the prevalence of preterm delivery, pregnancy-induced hypertension, cesarean section, meconium staining, infant birth weight, Apgar scores, intrauterine growth retardation, fetal distress, fetal death, neonatal seizures, sepsis, or admission to the intensive care unit.
This study demonstrates that physical assault during pregnancy is associated with preterm labor and chorioamnionitis. Screening for ongoing assault should be incorporated into routine prenatal care to identify women at risk of complications.
我们调查了身体暴力是否与不良产科结局独立相关。
我们将32名报告在孕期遭受身体虐待的贫困妇女的围产期结局与352名否认曾遭受暴力的对照对象的结局进行了比较。根据结构化访谈将患者分类到相应类别。进行逻辑回归分析以估计调整混杂因素后不良结局的相对风险。
与否认遭受暴力的妇女相比，当前孕期遭受暴力的妇女发生早产的可能性高出两倍。此外，粗略比值比显示暴力受害者发生绒毛膜羊膜炎的风险增加两倍。在早产、妊娠高血压、剖宫产、胎粪污染、婴儿出生体重、阿氏评分、宫内生长受限、胎儿窘迫、胎儿死亡、新生儿惊厥、败血症或入住重症监护病房的发生率方面，受虐待妇女与未受虐待妇女之间未发现差异。
本研究表明孕期身体暴力与早产和绒毛膜羊膜炎相关。应将正在遭受暴力的筛查纳入常规产前检查，以识别有并发症风险的妇女。
