Postpartum Depression and Intimate Partner Violence in Urban Mothers: Co-Occurrence and Child Healthcare Utilization
Postpartum Depression and Intimate Partner Violence in Urban Mothers: Co-Occurrence and Child Healthcare Utilization
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DOI：
10.1016/j.jpeds.2012.01.047
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发表时间：
2012-08-01
影响因子：
5.1
通讯作者：
Solomon, Barry S.
中科院分区：
文献类型：
--
作者：
Kornfeld, Benjamin D.;Bair-Merritt, Megan H.;Solomon, Barry S.
目的探讨产妇产后抑郁和亲密伴侣暴力筛查阳性的发生率、时机和共现性，并探讨其与儿童从出生到2岁的医疗保健利用的关系。研究设计：2008年2月至3月，母亲将新生儿、2个月、4个月或6个月大的婴儿带到城市初级保健诊所进行产后抑郁和亲密伴侣暴力筛查。一份回顾图表摘要介绍了人口统计数据、产妇在初次就诊和随后就诊时对产后抑郁症/亲密伴侣暴力筛查的反应，以及从孩子出生到两岁生日、坚持良好的儿童护理和使用儿科急性护理和急诊科就诊情况。结果173名母亲完成了至少一次产后抑郁症/亲密伴侣暴力筛查调查。总体而言，26%的人筛查出产后抑郁症，7%的人筛查出亲密伴侣暴力；大多数阳性筛查发生在第一次就诊时。在亲密伴侣暴力筛查阳性的母亲中，约60%的母亲也有产后抑郁症筛查阳性。良好的儿童护理依从性和急性护理访问利用与产妇产后抑郁/亲密伴侣暴力筛查无关。产后抑郁筛查阳性妇女的子女对急诊科的使用率较高。结论城市母亲产后抑郁与亲密伴侣暴力并存的比例较高。初级保健提供者应该定期筛查这一人群中的两个问题，如果发现另一个问题，则认识到筛查其中一个问题的重要性。(《儿科杂志》2012；161：348-53)。
Objective To assess the prevalence, timing, and co-occurrence of positive screens for maternal postpartum depression and intimate partner violence and examine their relationships with children's healthcare utilization from birth to 2 years.Study design Between February and March 2008, mothers bringing newborn, 2-, 4-, or 6-month-old children to an urban primary care clinic were screened for postpartum depression and intimate partner violence. A retrospective chart review abstracted demographic data, maternal responses on the postpartum depression/intimate partner violence screen at the initial and subsequent visits, and, from the child's birth to second birthday, adherence with well-child care and use of pediatric acute care and emergency department visits. Descriptive, bivariate, and multivariate analyses were conducted.Results A total of 173 mothers completed at least one postpartum depression/intimate partner violence screening survey. Overall, 26% screened positive for postpartum depression and 7% screened positive for intimate partner violence; most positive screens occurred at the initial visit. About 60% of mothers with a positive intimate partner violence screen also had a positive postpartum depression screen. Well-child care adherence and acute care visit utilization were not associated with maternal postpartum depression/intimate partner violence screening. Children of women with a positive screen for postpartum depression had greater emergency department utilization.Conclusion The co-occurrence of postpartum depression and intimate partner violence is high in urban mothers. Primary care providers should routinely screen for both problems in this population and recognize the importance of screening for one problem if the other problem is identified. (J Pediatr 2012;161:348-53).